Jeremy Hunt delivers a speech during a visit to the Evelina London Children's Hospital on July 5, 2013. Photograph: Getty Images.
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Jeremy Hunt's "hospital closure clause" could be a new NHS disaster for the Tories

At least 20 coalition MPs are expected to rebel against Clause 119 today, which would give administrators the power to close down any hospital or A&E without consultation.

After Andrew Lansley's botched NHS reforms, Jeremy Hunt became Health Secretary with a brief to take the service out of the headlines. But he's failed in that mission this week. Later today, MPs will debate what's been branded the "hospital closure clause". Introduced as a hurried amendment to the Care Bill, Clause 119 (formerly known as Clause 118) would give Trust Special Administrators, appointed by Hunt, the power to close or downgrade any hospital or A&E  in the country at just 40 days' notice (allowing no time for proper consultation) if a neighbouring NHS trust is in financial trouble. 

The measure was brought forward after ministers were ruled to have acted illegally by attempting to cut emergency and maternity services at Lewisham hospital after the South London Healthcare trust went into administration. Activists rightly argued that a well-performing and popular local hospital should not be made to pay for the price for failings elsewhere, and the High Court ruled in their favour. But Clause 119 would allow Hunt to overturn this defeat and ensure the government always triumphs in the future. 

The Health Secretary will get his way when parliament votes today, but he will do so in the face of significant resistance, not just from Labour but Lib Dems and Tories too. After revealing that there are 32 communities in England where NHS regulators have major concerns over the finances of trusts (and who could be left voiceless as a result of the measure), Andy Burnham has appealed to MPs to "put constituency before party" and block Hunt's plans. He said: "This Government used to say it wanted to put patients and doctors in charge of the local NHS. Now Jeremy Hunt wants to ride roughshod over local communities and have carte blanche to break up the NHS without anyone else having a say. He must be stopped.

"With more and more hospitals in financial difficulty, this move could hit every community in the land and leave them voiceless in the face of changes to their services.

"Labour is clear: changes to hospitals should be driven by clinical, not financial, reasons with local people involved every step of the way. That is why we believe these plans are dangerous and wrong. It is time for Parliament to stop an arrogant Secretary of State from overstepping the mark."

Burnham's cause is aided by the Coalition Agreement, which committed the government to ending "the centrally dictated closure of A&E and maternity wards, so that people have better access to local services." But the centrally dicated closure of services is precisely what Clause 119 would enable. 

Paul Burstow, the former Lib Dem health minister, who has tabled an amendment that would guarantee consultation rights for local people and give doctors who commission services a veto over any reorganisation, predicts that around 20 coalition MPs (who are increasingly preoccupied with their election chances) could rebel today. He said: "Support for my amendment has been growing. It feels to me that there's a growing disquiet on the Conservative side of the coalition about these plans, plus there are Liberal Democrat MPs who share the concern."

Burstow has won the support of his Lib Dem colleagues Andrew George, Julian Huppert and Mike Thornton, while Tory MPs Nick de Bois and Jeremy Lefroy are also likely to vote against the measure. De Bois, who led the Hands Off Our Hospital campaign against the downgrading of services at Chase Farm hospital in Enfield, said: "My constituents have seen first hand the flawed, unrepresentative consultations on the future of Chase Farm hospital … I have no intention of voting for a clause that reduces further the voice of patients and residents."

For the Tories, the row is a new political headache. Despite a concerted attempt to pin the blame for the Mid-Staffs scandal on Labour (including a lengthy section in David Cameron's conference speech), the opposition retains a double-digit lead on health (37-24 in the most recent YouGov poll). One party source told me that focus groups reacted "particularly strongly" when they were reminded of Cameron's past pledges on the NHS. By again exposing the Tories to the charge of broken promises, Hunt's hospital closure clause is in danger of becoming the new "top-down reorganisation". 

George Eaton is political editor of the New Statesman.

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The most terrifying thing about Donald Trump's speech? What he didn't say

No politician uses official speeches to put across their most controversial ideas. But Donald Trump's are not hard to find. 

As Donald Trump took the podium on a cold Washington day to deliver his inauguration speech, the world held its breath. Viewers hunched over televisions or internet streaming services watched Trump mouth “thank you” to the camera, no doubt wondering how he could possibly live up to his deranged late-night Twitter persona. In newsrooms across America, reporters unsure when they might next get access to a president who seems to delight in denying them the right to ask questions got ready to parse his words for any clue as to what was to come. Some, deciding they couldn’t bear to watch, studiously busied themselves with other things.

But when the moment came, Trump’s speech was uncharacteristically professional – at least compared to his previous performances. The fractured, repetitive grammar that marks many of his off-the-cuff statements was missing, and so, too, were most of his most controversial policy ideas.

Trump told the crowd that his presidency would “determine the course of America, and the world, for many, many years to come” before expressing his gratefulness to President Barack Obama and Michelle Obama for their “gracious aid” during the transition. “They have been magnificent," Trump said, before leading applause of thanks from the crowd.

If this opening was innocent enough, however, it all changed in the next breath. The new president moved quickly to the “historic movement”, “the likes of which the world has never seen before”, that elected him President. Following the small-state rhetoric of his campaign, Trump promised to take power from the “establishment” and restore it to the American people. “This moment," he told them, “Is your moment. It belongs to you.”

A good deal of the speech was given over to re-iterating his nationalist positions while also making repeated references to the key issues – “Islamic terrorism” and families – that remain points of commonality within the fractured Republican GOP.

The loss of business to overseas producers was blamed for “destroying our jobs”. “Protection," Trump said, “Will lead to great strength." He promised to end what he called the “American carnage” caused by drugs and crime.

“From this day forward," Trump said, “It’s going to be only America first."

There was plenty in the speech, then, that should worry viewers, particularly if you read Trump’s promises to make America “unstoppable” so it can “win” again in light of his recent tweets about China

But it was the things Trump didn't mention that should worry us most. Trump, we know, doesn’t use official channels to communicate his most troubling ideas. From bizarre television interviews to his upsetting and offensive rallies and, of course, the infamous tweets, the new President is inclined to fling his thoughts into the world as and when he sees fit, not on the occasions when he’s required to address the nation (see, also, his anodyne acceptance speech).

It’s important to remember that Trump’s administration wins when it makes itself seem as innocent as possible. During the speech, I was reminded of my colleague Helen Lewis’ recent thoughts on the “gaslighter-in-chief”, reflecting on Trump’s lying claim that he never mocked a disabled reporter. “Now we can see," she wrote, “A false narrative being built in real time, tweet by tweet."

Saying things that are untrue isn’t the only way of lying – it is also possible to lie by omission.

There has been much discussion as to whether Trump will soften after he becomes president. All the things this speech did not mention were designed to keep us guessing about many of the President’s most controversial promises.

Trump did not mention his proposed ban on Muslims entering the US, nor the wall he insists he will erect between America and Mexico (which he maintains the latter will pay for). He maintained a polite coolness towards the former President and avoiding any discussion of alleged cuts to anti-domestic violence programs and abortion regulations. Why? Trump wanted to leave viewers unsure as to whether he actually intends to carry through on his election rhetoric.

To understand what Trump is capable of, therefore, it is best not to look to his speeches on a global stage, but to the promises he makes to his allies. So when the President’s personal website still insists he will build a wall, end catch-and-release, suspend immigration from “terror-prone regions” “where adequate screening cannot occur”; when, despite saying he understands only 3 per cent of Planned Parenthood services relate to abortion and that “millions” of women are helped by their cancer screening, he plans to defund Planned Parenthood; when the president says he will remove gun-free zones around schools “on his first day” - believe him.  

Stephanie Boland is digital assistant at the New Statesman. She tweets at @stephanieboland