Health and Social Care Bill: a letter from Ed Milliband

A copy of Ed Miliband’s letter to members of the House of Lords has fallen into the hands of Liberal Democrat Voice. This is what he has to say…

Dear Member of the House of Lords

I am taking the unusual step of writing to you and all your fellow peers to share my very great fear for the future of the NHS. I know you are aware that the decisions you have to make over the next few weeks on the Health and Social Care Bill are of huge significance to the NHS and to the country. I can think of few times where the House of Lords has had a role of greater importance.

As it stands, I believe this Bill would undermine the quality and ethos of our NHS – especially Part 3, which seeks to import the model of the privatised utilities into healthcare. I fear it will lead to a fragmented service, pitting doctor against doctor and hospital against hospital, undermining the culture of co-operation and collaboration that has made our NHS so great. The reorganisation proposed by the Bill as it stands would also cost a vast amount of money – money that would be better spent protecting the frontline, such as the thousands of nursing posts set to be lost in this Parliament. It is also a matter of great concern that this Bill and its underlying intentions were hidden from the public before the general election.

I know the Labour team in the Lords, led by Glenys Thornton and Phil Hunt, are already working with many of you on this issue. On behalf of my Party, I want to extend this offer to peers of all parties and of none: we will work with you to stop this Bill damaging the NHS.

Recent weeks and months have shown just how widely the concerns about this Bill are shared – not just among patients and the public, but also amongst doctors, nurses and other NHS staff. The Government would have us believe that those who oppose this Bill are ‘vested interests’. I think that is deeply insulting to people who have their lives to working in the NHS and care about its future.

I want you to know that Labour has made an offer to put party differences aside and work with the Government on reform objectives we all share, such as greater clinical involvement in commissioing and the funding of social care. But ultimately, the NHS is too important to stand back and let this Bill damage it. I hope we can all work together to protect the future of our National Health Service.

Yours sincerely

Rt Hon Ed Miliband MP

So, how would you respond?…

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42 Comments

  • Seems fine to me.

  • Simon Bamonte 19th Feb '12 - 4:18pm

    On this issue, Mr. Miliband is correct and I agree with him 100%.

    During the 2010 general election, we were promised this: “No top-down reorganisations of the NHS.” Those are Mr. Cameron’s exact words. These reforms were not in the Conservative manifesto. They were not in the LibDem manifesto and I believe they were also absent from the coalition agreement.

    The medical profession by and large do not want these reforms. The public do not want these reforms. In fact, the “Stop the Bill” e-petition on the government’s own site is now over 140,000 signatures, the second most popular petition on the site.

    It is plain to see that covering up these reforms during the election and then pushing them against the wishes of the experts and, more importantly, the electorate is highly undemocratic. I’ve said it before: we could be on the side of the public and drop these reforms. It would be good political capital to be the one party who stopped reforms that even many Tories, including ministers, do not support.

    Sadly I don’t think this will happen. Clegg was quoted a week ago as being very angry with the Tories who are speaking out against the bill. He is more concerned with keeping Cameron sweet for 2015 than he is concerned with keeping the electorate and his own party sweet. Yet Clegg will push onward, ignoring the feelings of the public, the medical profession and the majority of his party.

    It’s time to drop this unpopular, undemocratic and dangerous bill.

  • John Carlisle 19th Feb '12 - 4:39pm

    Sadly, it is the Labour leader who has said what so many people across the UK believe. The direction of change apart a(which is wrong) anyone who has run any company of any size knows that it is impossible to implement. They could not even install an IT system, dammit.
    Indian Railways, a comparable size, refuses to “transform” by reorganisation; but continuallu renews itself division by division. What is being asked of for the NHS is equivalent to Gallipoli.

  • Gemma Roulston 19th Feb '12 - 4:45pm

    I think that the NHS is like the care system, they are too important to be constantly ping ponged and used as political football. This should be a matter of cross party consensus.
    This bill is not wanted by anyone but the elite of Cameron, Landsley and Clegg. Neither party campaigned for this, we were promised no top down re-organisation, was not in the coalition agreement. Yet no-one at the top – the government seem to be listening.
    The listening exercise was not really even that – it should have happened before the bill was introduced. The exercise was only for the invited. As a patient, and a parent/carer of people with speech impairments and learning disabilities – I would have liked along to make my feelings and thought known, but did not know where or when the meetings were.
    Yes you may say that the the BMA et al – are more for Labour than us, but they are more on the coal face than Cameron et al. The electorate do not want it, so why are we forcing this on everyone who does not want it. The NHS needs reform, but not in this way.
    The social care side will not get done until the government have decided to respond to Dilnot – the care side is a poor afterthought.

  • Tony Dawson 19th Feb '12 - 5:47pm

    Other than the twaddle about Labour, there seems nothing in that letter that a sensible Liberal Democrat could not have written.

  • For once well done Ed

  • The trouble with letters like this is it usually causes the opposite of what you achieve. The idea of a gloating Ed Milliband would be enough to make someone think again.

    However I have noticed a change in tactics from Labour recently – to claim everything the Lib Dems are trying achieve as Labour victories. The latest being Labour want a 10k personal tax allowance – and when the Lib Dems achieve it they will claim it was all their work. And annoyingly the media are playing along with this game.

  • Is this the reason Nick Clegg supports the health bill?

    http://eoin-clarke.blogspot.com/2012/02/is-this-540000-reason-that-nick-clegg.html

  • Foregone Conclusion 19th Feb '12 - 7:34pm

    Yes, gg, because plainly we’re in thrall to a healthcare company whose last donation was in 2008, months after Clegg became leader. Your graph is rather misleading on this point. Would you care to correct it?

  • Robert ford 19th Feb '12 - 9:18pm

    The trouble is they are really all the same. It was labour under Blair that started all this. I hope the bill is stopped. But all main parties are just a dishonest as each other.

  • On this one Milliband is absolutely right. And he is not Gordon Brown…..which is a plus.

  • He’s not wrong, but should he really have been given a chance to make such capital out of this. How did the Bill get this far, look at the archives of this site and it was being championed by Lib Dem Ministers in it’s original form. Millibland has been an awful opposition leader but even he cannot make a hash of this totally open goal.

    It is true the Royal Colleges have a vested interest, but the Royal College of GP’s is not exactly a hot bed of left wing activism.

    This, along with the Welfare Bill will cost the Lib Dem’s dearly. Labour will pin every delayed operation, every drug rationed, in fact every ailment with the NHS on the coalition. It will not be Tory voters they will aim at. Come 2015 it will be the Tory Bill the Lib Dem’s pushed through.

  • I am so ashamed that I voted Lib Dem in 2010 and in fact that I have for 20 years. What on earth was I thinking? Labour has my vote in 2015.

  • DJ, imho the HSC bill is moving along the same path that Labour charted with their market reforms of the NHS. I’m ashamed that the Lib Dem MPs have allowed it to get this far, but you’d be mad to vote Labour on the basis of this.

  • ” the quality and ethos of our NHS ”
    Don’t kid yourself Mr.Ed
    I knew an eldery man who went to see his GP
    because he was feeling unwell and was told to “pull himself together”
    The next week the man died.
    One of my relatives with a heart condition died
    before he could get a vital operation. Waiting lists!
    Quality for whom? The better off who want to get
    treatment without paying for it.

  • Jayne Mansfield 20th Feb '12 - 10:18am

    Cameron lied about his planned top down reorganisation. How can one trust him again?

    I admit to being a ‘vested interest. I am a patient who has reason to be happy with the life saving care that I have received over the years.

  • Jayne Mansfield 20th Feb '12 - 11:23am

    It is my understanding that GP commissioners are to get ‘quality payments’ if they make savings.

    Who will the GP commissioners be thinking of when they make savings, themselves or the patient?

    If this is the case, these financial incentives to save money w ill mean that the patient can no longer be certain that the doctor is making decisions in their best interests.

  • @DJ :

    “I am so ashamed that I voted Lib Dem in 2010 and in fact that I have for 20 years. What on earth was I thinking? Labour has my vote in 2015.”

    So. DJ, you want to vote for the party which not only deliberately continued Mrs Thatchers process of increasing the rich-poor divide for 13 years solid, and sold out to the big banks, but also forced every hospital in the NHS to farm out chunks of its work to the Pricate sector?

    Quite remarkable!

  • The principles of this bill, cutting bureaucracy by reducing arms-length bodies and helping hospitals tailor their services to their users by loosening Whitehall control, are good. But it seems to me that the government has attempted to sneak through a lot of other, entirely more controversial ideas through in the same bill.

    Marketisation of the service provision, for example. I don’t have a strong preference either for market or public provision, but the risk is we will swap a monolithic, bureaucratic public body for a monolithic, corporate private organisation, providing no benefit to the patient and making no great saving for the taxpayer. And then there’s the financial incentivisation of the GPs and the notion of giving them control over £80bn worth of budget in the first place.

    Regardless, we can debate the pros and cons of the policy till the cows come home and it won’t change the fact that its become politically toxic. With almost all the professional bodies in healthcare against the Bill, and while so many are unwelcome to even turn up at the consultations, the bill loses credibility. And among the public, even those who would favour a switch to a more insurance-based welfare system generally have come out in defence of the NHS.

    And the latest problem is that this bill, which proposes to hand the means of commissioning to the GPs,, has just excluded those GPs from its decision making process. That’s difficult to view in a positive light, really. Perhaps the time has come to scale back NHS reform ambitions and focus on achieving specific goals within the current legislative framework? Cutting quangoes, establishing an independent watchdog, granting hospitals more independence from Whitehall, none of that needs a new bill, from what I understand.

    Of course, I don’t agree with Miliband either – for all that the present positive aspects of the bill have been put together with a lot of the Tories’ ideological baggage, his ‘fragmented service pitting hospital against hospital’ I see as a ‘decentralised provision of services tailored to local needs’.

  • Jayne Mansfield 20th Feb '12 - 3:21pm

    Dear Richard Dan,
    You are correct that most GP’s are caring. As I stated I have one who fits that description.

    If this reorganisation is good for patients, why are GP’s such as my own opposed to it?

  • Jayne Mansfield 20th Feb '12 - 5:08pm

    DearMark Pack,
    My head is spinnin from the NHS Health and Social Care Bill and as an elderly person ( drain on resources) I have a vested interest what the future holds for me now that I am no longer a tax-paying citizen.

    How will bureaucracy (even if ne accepts that it is excessive)be reduced when the three layers of bureaucracy are tobe replaced by five?

    The government claims that it will give billions, 65 billions I think to GP’s . These are health workers whose decision making is held in such low regard that the Royal College of GP’s which represents 40.00 of them have not been invited to Downing Street to discuss the Bill. They are also the health providers who could not be trusted by the government to decide whether people were fit or able- bodied enough to work. The government puts more trust in ATOS and private profit makers than GP’s.

    Those GP’s who become part of the commissioning bodies, will they also be working as GP’s ? Where will those who went into medicine to treat the sick find the time to do both, especially as they have no skills as commissioners?

    Are you sure that GP commissioners will not just be the cover for private firms who will do the planning and commissioning?

    Finally,when the changes are going to cost around £2 billion and health service funding is not going to rise in real terms are you really expecting this old lady to believe that services will be awarded for quality of services rather than cost?

    I don’t pretend to understand the changes that are being made by this government because they seem to be a n incomprehensible dog’s dinner.

    Amazingly most of the criticism seems to be coming from Tories not Lib Dems.

  • Jayne Mansfield 20th Feb '12 - 5:10pm

    Sorry for the typos I suffer from macular degeneration and typing is a chore.

  • Dave Eastham 20th Feb '12 - 5:38pm

    @ Richard Dean

    Richard seems to be saying that he does not see the Bill as a threat to the NHS and it does not threaten to undermine co-operation between various medical institutions. I assume he also has a copy of the myriad amendments which we will take as read – and has managed to integrate them into the whole (good luck). Detailed chapter a verse here would be too long and boring so, may I make some suggestions where Richard can begin to look?. Try http://falseeconomy.org.uk/blog/key-points-of-the-dangers-in-the-health-and-social-care-bill and also look at the writer of this article’s blog http://nhsvault.blogspot.in/ for a series of articles and some detailed analysis also from the same pen/keyboard at at https://sites.google.com/site/nhsfuture/Home . Whilst I have just suggested one source, there are many discussion forums with many opinions of various levels of objectivity and accuracy. A quick google/bing/ask or whatever search engine you use, will throw up many possibilities.

    Now obviously it can always be said that “vested interests” are involved in anything. However, in truth the term is much over used (much like “illiberal” in Lib Dem discussions sometimes) and really only is a description of an opinion/viewpoint. The BMA may have many faults and I certainly don’t include myself in their “fan-club” but they are a professional organisation that are capable of objective and honestly held opinions. I know it is always trotted out that the BMA’s vested interests opposed the setting up of the NHS. They did but a half told story can be undermined by the details of history. (The truth is much more prosaic. Read Michel Foot’s biography of Aneurin Bevan). Vested interests are when undeclared selfish interests are dishonestly dictating your public position which masquerading as something else. I really don’t think that applies here, or indeed to any of the Health Professional Organisations and Trade Unions that are voicing concerns (and that includes the union I am a member of – Unite). In truth I m more concerned of the alleged “vested” interests of some of the MP’s and Lords who have been/will be voting on this matter. See http://socialinvestigations.blogspot.com/2012/02/nhs-privatisation-compilation-of.html
    Long detailed explanations of how this bill will undermine the collaborative working practices of the NHS are not for here but I cannot resist quoting a recent contribution to Conservative Home (not a common source of quotations on LDV!), from someone describing themselves as a “staunch conservative doctor”, TrueBlueDoc: referring to the likely effects of the bill on on Sexual Health services
    “There are also specific pathways that are a complete mess – take a look at sexual health. Chlamydia testing will be done by the local authorities. Contraception provided by GPs will be commissioned by the national commissioning board through its primary care commissioning department. Long acting contraception commissioned by the clinical commissioning groups. HIV care and we are back into the National Commissioning Board again, but this time a different department, the Specialised Department. What a mess. With the PCT, the buck stopped with the Accountable Officer and Chief Financial Officer. Ok they were often insufficiently accountable, but at least you could argue that as commissioners of the whole lot their necks were the ones that should be chopped.”

    As I have said before in other threads on LDV, in my opinion this chaotic Bill does not fit any of the ambitions for integrated Health and Social Care that has been the aspiration of Lib Dems for years. It does not fulfil the
    demands of the amended motion at the Spring 2011 Lib Dem conference and imho, Lib Dem support should be withdrawn. I just hope the PLDP is paying attention.

    Dave Eastham
    p.s the Labour Party, it should be remembered, were not adverse to a bit of “privatisation” of the Health Service themselves. One can only hope the sinners have truly repented. We Lib Dems hold the key to this. With Coalition we were suppose to moderate Tory excesses. Well now is the time to step up to this one!
    p.p.s. sorry the links don’t seemed to have survived pasting in please paste them into your browser.

  • Dave Eastham 21st Feb '12 - 8:20am

    @ Richard Dean

    As a former Biomedical Scientist who has, during my professional career, at times performed the “Cross matching” procedures involved in blood transfusions, I was horrified to read of the incompatible transfusion experienced by your mother. I hope she is now fully recovered. However, such incidents are extremely rare and always investigated. They are either found to be “human error” or more rarely, the result of a previously unforeseen flaw in the S.O.P. (Standard Operating Procedure) that govern these things. Which are then corrected to prevent recurrence. Sadly, nothing is ever perfect. What such incidents are certainly not, are any contribution to the method of provision of health care by the NHS in England. There have been some horrendous incidents in the past in the Private Healthcare sector as well. Which does not “discredit” the Private Sector as a health provider per se either.
    In discussing any policy we should be objective about the proposals and frankly policy development by individual anecdote, however personally devastating, has minimal relevance.. For instance the latest annual NHS patient satisfaction survey, which effectively covers the period 2010-2011 and has been running many years. (The funding for which incidentally has been cancelled by Lansley). It shows the satisfaction rating at 97%, the highest it has ever been. (the lowest was 34% in 1996/97 wonder who was in Government then?)
    The websites I pointed to you were intended as a start. Whilst the author may have a set of beliefs that largely pre-determine their ultimate conclusions. I don’t think the analysis itself was un-objective. For instance it did refer to the implications of the abolition of NHS Trusts in 2014 which has a serious danger of opening up the provision of Health Care in England and possibly the rest of the UK, to European Competition law. Which it is currently exempted under a European Court ruling from 2003 which exempted the British NHS under the social function non profit making exemption to the Competition laws. That is a matter of fact not opinion. I consider that to be a bad thing.

    The NSC bill may be many things but what it certainly is not is an operating manual for the provision of the minutiae of individual services. The whole point of the example from the “Tory” doctor was that in his/her area of expertise they could see the implications of the mechanisms set in place by the Bill and they were far from collaborative. I could have chosen any number of examples but my sense of irony led me to use the Tory one. Of course it’s not directly in the Bill.

    I can only repeat that imho, the Bill makes a minimal contribution to Lib Dem Healthcare aspirations. Indeed, I would go so far as to say in undermines them. It seems that a growing number of people in the Party are coming to various conclusions why the Bill is not fit for it’s purpose and should be withdrawn. I agree with that conclusion. Others may have a different conclusions but everyone should base their decisions on objective analysis.

  • Jayne Mansfield 21st Feb '12 - 12:21pm

    I too am extremely sorry to read of the experience of Richard Dean’s mother.

    I am afraid that the ongoing scandal of PIP breast implants and the refusal of the private healthcare providers to help the women concerned demonstrates only too clearly that medical errors or negligence are not confined to the NHS.

    I don’t see how being a ‘former’ biomedical scientist categorises one as a vested interest. I have a vested interest because I am a patient and what happens to the NHS is still important to my interests.

    It seems that even the representative of organisations who were selected to attend Downing Street, offered criticisms of the NHS and Social Care Bill.

    Where is the transparency? What does the risk register say?

    Discovering that a Tory MP ‘forgot’ to mention that he was paid £50,000 a year by Circle Health when he spoke in favour of the Bill in health debates and that 30 Peers from across the political spectrum have interests in private healthcare companies means that this issue is becoming one of trust ( or lack of) in the motivation of those who favour a bill that opens the NHS up to private healthcare companies.

  • Jayne Mansfield 21st Feb '12 - 2:15pm

    Richard Dean.
    The NHS has constantly changed. There were numerous reorganisations under Labour, hence Cameron’s promise that there would be no top down reorganisation.

    It seems to me that what the NHS needs is stability, especially when the surveys showed rising consumer satisfaction and improvements in health care. Especially when there will be cuts in healthcare spending in real terms.

    Every report that I have read has stated that any reform that was required did not require the passing of this bill, that includes the move to form GP commissioning groups.

    I think that the fact that Andrew Lansley ‘s office was partly funded by a private healthcare company, that the BBC has disclosed that a Tory MP who spoke in suppport of Mr Lansley’s ‘reforms’ in parliament whilst ‘forgetting’ to mention that he was being paid £50,000 as an advisor to the private health care company, and that Peers who have vested interests are making decisions that will impact on our NHS.

    In fact, the disclosures are starting to leave a rather nasty taste in the mouth.

    What do these private health care companies get in return for the very large amounts they pay to politicians?

    What is the Quid Pro Quo?

  • Jayne Mansfield 21st Feb '12 - 3:07pm

    Geriatric? Geriatric?- that term is a bit close to the bone for me Richard.

    We can all quote anecdotal evidence but it doesn’t alter the fact that research showed that satisfaction with the health service was at its highest level since the inception of the NHS when the Tories took over.

    After a life time of hard work, I am terrified that at a time when I now need an NHS that I have contributed to through my NI contributions and taxes is going to be hived off to the profiteers of the private healthcare sector.

    In what way would I and others like me be better cared for in a system that puts profit before people than in a socialised system?

    David Cameron the spinmaster can argue that the problem with the ‘reforms’is that they have not been properly explained or understood. Wrong. People like myself are beginning to understand them very clearly thanks to explanations from GP’s, Nurses , Opthalmologists etc. we come into contact with and have come to trust.

    If David Cameron really thinks that the problem is one of poor communication, why doesn’t he spend the time until the next election explaining the reforms, and then we can make a judgment and vote for whether we want his NHS reforms at the next election?

  • Jayne Mansfield 21st Feb '12 - 4:21pm

    Good luck to Charles West.

    Please fight for you preferred option to have the entire bill dropped.

    It won’t be the consumate PR ‘wriggler’ and his party that will be blamed for the destruction of the NHS, it will be the party that enabled them.

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