Will the Lib Dems halt Hunt's backdoor NHS privatisation?

Health secretary promises to address "concerns" over Section 75 of the NHS bill after pressure from Lib Dems and Labour.

When the government's Health and Social Care Bill was finally passed by Parliament last year it was on the condition that GPs would not be forced to open up NHS services to private competition.

Andrew Lansley, the-then Health Secretary, told the Commons: "There is absolutely nothing in the Bill that promotes or permits the transfer of NHS activities to the private sector". In a letter to Clinical Commissioning Groups, he wrote:

I know many of you have read that you will be forced to fragment services, or put them out to tender. This is absolutely not the case. It is a fundamental principle of the Bill that you as commissioners, not the Secretary of State and not regulators – should decide when and how competition should be used to serve your patients interests. 

Having accepted Lansley's assurances, the Lib Dems granted the bill their support. But new regulations published under Section 75 of the act flatly contradict the government's promises. The guidelines state that commissioners may only award a contract without competition if they are "satisfied that the services to which the contract relates are capable of being provided only by that provider". In practice, then, GPs will be forced to open up all NHS services to private companies, regardless of the wishes of local people, with the healthcare regulator Monitor granted the power to block any "unnecessary" restriction of competition. 

Secondary legislation like this is normally nodded through parliament without debate but Labour, smelling a rat, warned that the regulations amounted to an attempt at backdoor privatisation. Jeremy Hunt, Lansley's replacment as health secretary, initially sought to dismiss the opposition's concerns. In response to a question from Jamie Reed, the shadow health minister, he declared: "Who exactly are the section-75 bogeymen [he] hates: Whizz-Kidz, who are supplying services to disabled children in Tower Hamlets? Or Mind, which is supplying psychological therapy to people in Middlesbrough?"

But after the Lib Dems joined Labour in raising concerns, Hunt has been forced to think again. Norman Lamb, the Lib Dem health minister, told his party colleague Andrew George, one of those opposed to the regulations, "We are looking at this extremely seriously. Clear assurances were given in the other place during the passage of the legislation, and it is important that they are complied with in the regulations."

In reponse, as today's Guardian reports, Hunt has made it clear that he is prepared to rewrite the new guidelines. A source tells the paper: "We are aware that there are concerns over the wording and the way it may be interpreted. We are speaking to the Lib Dem peers to make sure they are happy. We want to make sure everyone is happy."

The shadow health secretary, Andy Burnham, said in response: "The government has been caught out trying to force through privatisation of the NHS by the back door.

"This is another humiliating U-turn to add to the government list, but we believe ministers will stop at nothing to drive through their plans to put the NHS up for sale to the highest bidder."

But will this be anything other than a comestic rewrite? Ahead of the Lib Dems' spring conference next month, this is a key test of the party's nerve. 

Health Secretary Jeremy Hunt speaks at the Conservative conference in Manchester last year. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Show Hide image

Bertie Carvel's diary: What would the French think about infidelity to Doctor Foster?

The joy of debuting a new series, Rupert Murdoch's squeamishness and a sting in the tail.

According to the adage, the first thing an actor does when he gets a job is to go on holiday. And so, having finished our sold-out run of James Graham’s Ink at the Almeida and with the show (in which I play a young Rupert Murdoch) about to transfer into the West End, I’m packing my bags.

But before I can skip town, I’ve one more professional engagement: the press launch of series two of the BBC drama Doctor Foster, which we finished filming at Christmas. I’ve now seen the final cut of all five episodes, and I’m excited to share it with an audience. There’s no substitute for seeing other people’s reactions at first hand, especially with a show that got people talking so much first time around, and it’s electric to sit in a cinema full of expectant journalists and commentators and feel the room respond. Nothing beats this: to put so much into making a thing and then experience an audience’s unmediated, reflexive reaction. When it goes well, you feel that you’ve shared something, that you’ve all recognised something together about how things are. It’s a unifying feeling. A sort of bond.

Cheating spouses

Handling the interviews has been tricky, when there’s so little one can say without giving the plot away. (The first series began with Suranne Jones’s character Gemma, a GP, suspecting her husband Simon of having an affair.) What’s more, lots of the questions invite moral judgements that I’ve tried my best to avoid; I always think it’s really important not to judge the characters I play from outside, but simply to work out how they feel about themselves, to zero in on their point of view. There’s a sort of moral bloodlust around this show: it’s extraordinary. People seem to want to hear that I’ve been pilloried in the street, or expect me to put distance between myself and my character, to hang him out to dry as a pariah.

While I’m not in the business of defending Simon Foster any more than I’m in the business of attacking him, I am intrigued by this queer mixture of sensationalism and prurience that seems to surface again and again.

Shock horror

Oddly enough, it’s something that comes up in Ink: many people have been surprised to find that, in a story about the re-launch of the Sun newspaper in 1969 as a buccaneering tabloid, it’s the proprietor who considers dropping anchor when the spirit of free enterprise threatens to set his moral compass spinning.

I’ve never given it much thought before, but I suppose that sensationalism relies on a fairly rigid worldview for its oxygen – the SHOCKERS! that scream at us in tabloid headlines are deviations from a conventional idea of the norm. But what’s behind the appetite for this sort of story? Do we tell tales of transgression to reinforce our collective boundaries or to challenge them?

For me there’s a close kinship between good journalism and good drama. I’m reminded of the words of John Galsworthy, who wrote Strife, the play I directed last summer, and who felt that the writer should aim “to set before the public no cut-and-dried codes, but the phenomena of life and character, selected and combined, but not distorted, by the dramatist’s outlook, set down without fear, favour, or prejudice, leaving the public to draw such poor moral as nature may afford”.

So when it comes to promoting the thing we’ve made, I’m faced with a real conundrum: on the one hand I want it to reach a wide audience, and I’m flattered that there’s an appetite to hear about my contribution to the process of making it; but on the other hand I think the really interesting thing about the work is contained in the work itself. I’m always struck, in art galleries, by how much more time people spend reading the notes next to the paintings than looking at the paintings themselves. I’m sure that’s the wrong way around.

Insouciant remake

En route to the airport the next morning I read that Doctor Foster is to be adapted into a new French version. It’s a cliché verging on racism, but I can’t help wondering whether the French will have a different attitude to a story about marital infidelity, and whether the tone of the press coverage will differ. I wonder, too, whether, in the home of Roland Barthes, there is as much space given to artists to talk about what they’ve made – in his 1967 essay, “The Death of the Author”, Barthes wrote that “a text’s unity lies not in its origin but in its destination”.

No stone unturned

Touring the villages of Gigondas, Sablet and Séguret later that evening, I’m struck by the provision of espaces culturels in seemingly every commune, however small. The French certainly give space to the work itself. But I also notice a sign warning of a chat lunatique, so decide to beat a hasty retreat. Arriving at the house where I’m staying, I’ve been told that the key will be under a flowerpot. Lifting each tub in turn, and finally a large flat stone by the door, I find a small scorpion, but no key. I’m writing this at a table less than a yard away so let’s hope there won’t be a sting in this tale.

Ink opens at the Duke of York Theatre, London, on 9 September. More details: almeida.co.uk

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear