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13 July 2012

Lansley opens the door to full-scale NHS privatisation (Updated: no, he doesn’t)

The 49% cap on private work done by NHS trusts will be abolished.

By George Eaton

Update 2: Just to clarify, this piece was based on a Financial Times story, which the Department of Health has told us is incorrect. The FT has silently changed the headline, standfirst and content of its story. However, we have decided to leave this piece online, with the relevant correction.

Update: The Department of Health has been in touch to say that the cap is not being removed, rather that the planned 49% limit will be introduced from 1 October 2012.

The spokesman added: “Services for NHS patients will still be protected as the Health and Social Care Act 2012 sets out that foundation trusts still have a core legal duty to provide services to them.  The majority of their income must also come from NHS sources.  Income from non-NHS sources will also be reinvested back into wider hospital services, to benefit NHS patients.”

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When the government unveils a policy change on a Friday it’s a sure sign that it doesn’t want you to notice. Today, Andrew Lansley will announce that the 49% cap on private work done by NHS hospitals, which his bill introduced, will be abolished. In other words, the Health Secretary has just opened the door to the full-scale privatisation of the NHS, with hospitals able to raise 100% of their income from private healthcare.

Sue Slipman, the chief executive of the NHS Foundation Trust Network, describes the removal of the cap as “a really creative way of bringing more money into the health service”. What she doesn’t say is that foundation trusts, in pursuit of profit, will likely prioritise the treatment and care of private patients over NHS ones. Since the most profitable procedures are usually the simplest, those requiring more complex treatment will be pushed to the back of the queue. As Howard Catton, head policy at the Royal College of Nursing, has previously warned: “NHS patients may feel a subtle pressure to reach for the credit card.” Since all of the remaining 113 NHS trusts are required to become self-governing foundation trusts by April 2014, the removal of the cap will apply to all NHS services – hospitals, ambulances, mental health, community services and clinics.

What makes this change so unexpected is that Lansley’s original plan to place no ceiling on private treatment was rejected under trade union and Liberal Democrat pressure. There are two possible explanations: either the Lib Dems signed off on the policy or they weren’t told. Either is disastrous for their credibility.