Patient care, not private profit. How we want to amend the health and care bill

Justin Madders
© UK Parliament/Jessica Taylor

73 years ago, a Labour government created the National Health Service. Its introduction transformed lives, giving access to world-class healthcare for all, regardless of their ability to pay. If there’s one thing the Tories shouldn’t touch, it’s our NHS. They voted against its establishment 22 times and they have never been on its side. And yet, they keep trying to change the way it operates.

Against a backdrop of record-breaking waiting lists and in the face of what might be the most difficult winter the NHS has ever seen, Sajid Javid is at it again, with the health and care bill, which is due to be considered in detail by a committee of MPs in the Commons.

11 years of Tory cuts left our health and care services weakened and exposed when the pandemic hit, and the result of this neglect is that the NHS now faces unprecedented challenges. And yet, this bill does nothing to address them.

It makes no attempt to reverse the impacts of chronic underfunding and an almost insoluble staffing crisis. It does not address the crisis in social care. It will not help reduce the enormous backlog of elective treatment and it is far from clear what benefits the bill will bring for patients, carers, families or communities.

Instead, it proposes yet another top-down reorganisation of the system, to happen as the NHS is recovering from the impact of the pandemic and continuing to battle with its the long term consequences. This is unnecessary and misguided. It will not deliver more care but in fact, in periods of stretched health funding, I fear it could well deliver less.

I will lead Labour’s response to the bill in this committee and can assure you we will be doing all we can to try and limit the worst of the damage. After a year when billions in taxpayers’ money has been handed out to Tory cronies for duff PPE and testing contracts, I want to see a National Health Service where funding goes towards patient care, not private profit.

Labour will seek to ensure that decision-making bodies are fully transparent, with proper representation and genuine accountability for their actions and performance. We will push for meetings to take place in public, and seek to ensure that plans are properly subject to independent evaluation of affordability, to prevent local Boards becoming a vehicle for passporting central government cuts that limit the quality of services they can provide.

Where the bill brings in the need for a greater role for local authorities and others to build better place-based approaches to wellbeing and reducing inequality, we will seek to make these effective so that influence is genuine and meaningful. There has to be far more, and far better, ways to involve the patients, the public and staff in all aspects of decision-making.

We will strongly resist further privatisation of our NHS, by seeking to remove any possibility that private, profit-motivated firms can have any role in the boards of the new organisations. While I’m pleased that the damaging and bureaucratic competition rules of the Lansley Act will be finally scrapped, the bill falls woefully short of safeguarding against private sector involvement in our NHS.

It is missing clauses to make the NHS the default provider of care, so it would be possible for the proposed Integrated Care Boards to award and extend contracts for healthcare services of unlimited value to private companies, without advertising.

Given this government’s reckless and wasteful approach to public spending, with pandemic contracts lining the pockets of ministers’ mates, we are worried about further cronyism, and so will seek to amend the bill to ensure this cannot come to pass. We want to ensure the proposals to get rid of competitive tendering extend to non-clinical services, too, so they do not remain fair game for more outsourcing.

We will also challenge greater powers for ministers to interfere with the running of the NHS, which undermine its operational independence. We want to the Secretary of State to be both politically and operationally responsible for the health service, but not in the way this bill is framed – where he can pick and choose when to interfere, almost certainly on party political grounds.

Instead, we’ll seek to make sure the bill holds the government to account for the chronic workforce shortage across our healthcare services and strengthens duties to build the necessary workforce we desperately need, to recover from Covid and to tackle the enormous elective backlog of elective treatment.

Underpinning all of our efforts in committee will be a guiding principle of ensuring the NHS provides universal and comprehensive care for everyone when you need it.

Labour created the NHS and we will always protect it. With a large Tory majority on the committee, we will have a mountain to climb, but we will fight for our NHS with every amendment, in every debate and at every vote.

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