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“.