Labour’s 2006 NHS Act deliberately opened up health services, including acute hospitals, to wide-ranging competition on price, not quality. Labour’s legislation allowed private companies to receive £250m for contracts which they never delivered. Liberal Democrat peers are working hard to ensure that the NHS, including Foundation Trusts (FTs), remain public services.
Indeed, in order to protect them from the full force of competition law and the threat of takeover by American healthcare companies, hospitals must not be deemed ‘undertakings’ or look more like private sector bodies. One way to achieve that is to make it explicit in law that the majority of their income must come from public funds. So a cap of 49% is an important way of keeping our hospitals as public services.
The Health and Social Care Bill currently contains a proposal to cap the amount of private income and to require all Foundation Trusts to explain annually how that income has been used to benefit its NHS services. Liberal Democrat peers are arguing for a ‘belt and braces’ requirement that any FT which intends to increase significantly its private income must have prior approval from its board of governors. We are doing this because we believe that the NHS should demonstrate, with full transparency, how it delivers a comprehensive national health service for NHS patients.
At present, with the exception of specialist trusts such as the Royal Marsden, most FTs raise less than 5% of income from private sources. That could remain the case in future; as the cap is a maximum and not a target. Lib Dem peers are also continuing to press the Government to enable Monitor to negotiate much lower caps in individual trusts.
The NHS has been generating private income since 1948. There are those who believe that it shouldn’t. But today, there are some services, such as fertility treatment, which are mostly delivered privately. At the moment profits from these services go straight into the pockets of shareholders of private companies. As Liberal Democrats we would rather see that money benefitting the NHS.
As one GP pointed out recently: “If my local trust could take money away from the private sector and use it to fund the extra neonatal beds which my patients really need, I would be more than happy.”
In essence we are working to ensure NHS patients come first, a principle our party has always upheld.