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.

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Google’s tax worries, Oxford’s race dilemma and the left-wing case for leaving Europe

The truth is that many black students looking at the white, middle-class Oxford would justifiably conclude that they don’t belong.

As a Gmail user and a Google searcher, am I morally compromised by using the services of a serial tax avoider? Surely not. Google gets roughly 95 per cent of its revenues from advertising and much of that from clicks on the ads that surround its offerings. I have long observed a rule never to click on any of these, even when they advertise something that I need urgently. Instead, I check the seller’s website address and type it directly into my browser.

Taking full advantage of its services without contributing to its profits strikes me as a very good way of damaging the company. More problematic are pharmaceutical companies such as AstraZeneca (zero UK corporation tax in 2014) and GlaxoSmithKline (UK corporation tax undisclosed but it has subsidiaries in tax havens), which makes many prescription drugs and consumer products such as toothpaste – I chew it to stop me smoking. To boycott all such companies, as well as those that underpay their workers or pollute the planet, one would need, more or less, to drop out from the modern world. Consumer boycotts, though they have a certain feel-good factor, aren’t a substitute for electing governments that will make a concerted effort to tax and regulate big corporations.

 

After EU

David Cameron is finding it hard to get changes to EU rules that he can credibly present as concessions. But the talks that would follow a vote for Brexit would be a hundred times more difficult. Ministers would need to negotiate access to the single market, renegotiate trade deals with 60 other countries and make a deal on the status of Britons living in the EU, as well as EU citizens living here. All this would create immense uncertainty for a fragile economy.

With a current-account trade deficit of 4 per cent, the dangers of a run on sterling would be considerable. (This apocalyptic scenario is not mine; I draw on the wisdom of the Financial Times economics editor, Chris Giles.) But here’s the question. If the UK got into the same pickle as Greece – and George Osborne had to do a Norman Lamont, popping out of No 11 periodically to announce interest-rate rises – Jeremy Corbyn would walk the 2020 election. Should we lefties therefore vote Out?

 

University blues

Hardly a Sunday now passes without David Cameron announcing an “initiative”, either on TV or in the newspapers. The latest concerns the under-representation of black Britons at top universities, notably Oxford, which accepted just 27 black students in 2014 out of an intake of more than 2,500. As usual, Cameron’s proposed “action” is risibly inadequate: a requirement that universities publish “transparent” data on admissions and acceptances, much of which is already available, and a call for schools to teach “character”, whatever that means.

The truth is that many black students looking at the white, middle-class Oxford – with its disproportionate numbers from a handful of fee-charging schools, such as Eton – would justifiably conclude that they don’t belong. Cameron rules out quotas as “politically correct, contrived and unfair”. But quotas in some form may be what is needed if young people from poor white, as well as black, homes are ever to feel that they would be more than interlopers.

In the meantime, Cameron could tell elite universities to stop setting ever-higher barriers to entry. As well as demanding two A*s and an A at A-level, Oxford and Cambridge are introducing tests for “thinking skills” and subject-specific “aptitude”. Whatever the developers of such tests claim, it is possible to coach students for them. State schools don’t have the resources to do so or even to research the complex requirements of the various colleges and subjects. Oxbridge admissions tutors must know this but evidently they don’t care.

 

A fine balance

The latest government figures show that, despite the former education secretary Michael Gove introducing £60 fines for parents who take their children on term-time breaks, the days lost to unsanctioned holidays are up by 50 per cent to three million in four years. This was a predictable result. Previously, the sense of an obligation to respect the law and set their children an example of doing so persuaded most parents to confine absences to school holidays. Now a modest price has been placed on term-time holidays. Parents do the sums and note that they save far more than £60 on cheaper flights and hotels.

A similar outcome emerged in Israel when daycare centres introduced fines for parents who arrived late. Previously, most preferred to avoid the embarrassment of apologising to a carer and explaining why they had been delayed. Once it became just a monetary transaction, many more happily arrived late and paid the price.

 

Minority report

Here in Loughton, Essex, where I live quietly and unfashionably, we are dancing in the streets. Well, not quite, but perhaps we ought to be. According to an analysis by the Policy Exchange think tank, Loughton is the third most integrated community in England and Wales, just behind Sutton Coldfield in the West Midlands and Amersham, Buckinghamshire, but above 157 others that have significant minorities. We are well ahead of fashionable London boroughs such as Islington and Hackney, where residents obviously keep Muslims and eastern Europeans out of their vibrant dinner parties, whereas we have bearded imams, African chiefs in traditional dress and Romanian gypsies dropping in for tea all the time.

Again, not quite. I’m not sure that I have met that many non-indigenous folk around here, or even seen any, except in the local newsagents. Still, I am grateful to Policy Exchange for brushing up Loughton’s public image, which was in need of a facelift after the BNP won four seats on the council a few years ago and a TOWIE actor opened a shop on the high street.

Peter Wilby was editor of the Independent on Sunday from 1995 to 1996 and of the New Statesman from 1998 to 2005. He writes the weekly First Thoughts column for the NS.

This article first appeared in the 05 February 2015 issue of the New Statesman, Putin's war