The Health and Social Care Bill has been passed for the third and final time in the House of Commons yesterday, after a two-day debate.
The Bill, which secured a majority of 65 votes with only four Liberal Democrat MPs voting against it, now goes on the House of Lords.
A major issue of contention was Health Minister Lord Howe’s statement this week that the NHS reforms mean “huge opportunities” for private health providers.
Prime Minister David Cameron’s claim that the Bill now has the support of GPs and nurses was also challenged by relevant professional bodies.
The Government’s ‘listening exercise’ resulted in changes that toned down the Bill’s emphasis on competition between providers – for example, changing the proposed core duty of Monitor from promoting competition to protecting and promoting “the interests of patients”.
However, claims that these changes represented a major policy shift were challenged by Lord Howe’s statement, made this week to a meeting of private health groups in London, that the new legislation would create “huge opportunities” for them.
“I don’t think it should matter one jot whether a patient is looked after by a hospital or a medical professional from the public, private or charitable sector,” he added.
BMA spokesman Dr Laurence Buckman BMA commented: “Lord Howe's comments betray how deep the government's misguided obsession with competition goes.
“Encouraging private providers in, in this way, to compete against other providers will only make it harder for clinicians to work together effectively – and it's that, not competition, which improves patient care and the cost-effectiveness of the NHS.”
In the course of the Commons debate, Health Secretary Andrew Lansley claimed it was “ludicrous scaremongering” to assert that the Health Bill would lead to NHS privatisation, since the NHS would remain a free service.
However, as critics have pointed out, certain aspects of privatisation are indisputably part of the NHS reform programme. The rationing of NHS services – for example, making cataract and orthopaedic surgery available only in the most severe cases – is already a reality, while increasing the role of the private sector in NHS service provision is a firm aspect of Government policy.
The Commons debate revolved around issues that have remained contentious since the first version of the Bill, including provider competition, the role of the National Commissioning Board, and the question of how patient care will be maintained when ‘failing’ Foundation Trusts go out of business.
The chief concern of the Health and Social Care Bill’s critics in the NHS and Parliament remains that it will destabilise the NHS, with provider competition resulting in progressive privatisation.
David Cameron’s claim that the Bill enjoys the support of “the Royal College of GPs, the physicians, the nurses, people working in the health service” prompted criticism from two relevant professional organisations.
- Dr Peter Carter, General Secretary of the Royal College of Nursing, said: “At a time when the NHS needs to find £20bn in efficiencies, tackle waste, work harder to prevent ill-health and deal with an ageing population, this bill risks creating a new and expensive bureaucracy and fragmenting care.”
- Dr Clare Gerada, Chair of the Royal College of GPs, commented: “We are extremely worried that these reforms will lead to an increase in damaging competition, an increase in health inequalities, and to massively increased costs in implementing this new system.”
While it has won a major political battle in its campaign for market-led NHS reforms, the Government still has to gain the support of those clinicians it has repeatedly claimed it wants only to ‘empower’.