Over the last week I have been working with 38 degrees who ran a strong campaign raising concerns about a key clause in the Care Bill that made changes to the way in which a hospital in serious financial or clinical trouble would be handled in the NHS.
Trust special administration (TSA) as it is known, was introduced by Labour in 2009. It is a blunt process that should only ever be used in exceptional circumstances of financial or clinical failure. The principle was welcome, but when I looked closely, I felt the execution left unintended gaps in local accountability and a democratic deficit, and that’s why I took up the issue.
For me the starting point must be that decisions about the future of local health services are grounded in clinical evidence, supported by local clinicians, and drawn up with the active involvement of local people.
In the last few days, with the support of emails from 38 Degree members to MPs and the 159,000 petition signatures they collected, the Government has made important changes and concessions to strengthen democracy within the TSA process and give local people and local commissioners a more influential voice. The amendment played a vital part in getting Ministers’ attention and I am pleased to have spearheaded it.
I was also pleased to hear Ministers yesterday give Parliament the assurance that everything possible will be done to help any potentially failing hospital to sort out their difficulties so that a TSA is only ever used in rare and extreme circumstances.
Following my lobbying, Ministers have amended the Bill to strengthen public and patient involvement by the inclusion of local Healthwatch. In addition, local councils are being added for the first time too. In the Lewisham case the local Council played a vital role in standing up for local people.
Also as a result of the changes we have secured TSAs will now have to consult with NHS Trusts and their staff, as well as with commissioners (CCGs) of any affected NHS organisations. And as a result of the amendment Ministers have conceded that equal weight must be given to views of each involved Trust, staff and commissioners. Finally the Minister confirmed in response to my amendment that any TSA plan must have the agreement of ALL relevant commissioners.
When it came to pushing the amendment to the vote I had to make a fine judgement. Having secured important changes and commitments from the Government I took the view that pushing the amendment to a vote ran the risk of defeat and sacrificing what the Government had offered.
That is not the end of the matter. A cross party committee of MPs and Peers will be set up to agree the guidance to TSAs. I will be chairing that Committee – unpaid – and I will continue to engage with members as we draw up the rules to make sure the views of local clinicians and local people are heard loud and clear.
* Paul Burstow is Liberal Democrat candidate for Sutton and Cheam and was the MP until the dissolution of Parliament on 30th March.
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15 Comments
Thank you Paul, you’ve done us all proud by using the power of Parliamentary Backbenchers to alter government legislation.
Not that you’ll be able to get Labour to admit it, ofc.
As someone who now routinely deletes emails from 38 degrees, I hope that they won’t take this outcome as a reason to be further dominated by one political party (Labour).
Had Paul Burstow given 38 degrees the impression of being ready to rebel for rebellion’s sake? How wrong they were. Well done Paul.
Oh dear, the spin doctor and his disciples have arrived.
Its just another step closer to the end of the NHS we know and love, its what the tories have always wanted and the LDP have enabled them every step of the way.
Well done Paul indeed.
So now Hunt can finally close down Lewisham. Well done Paul. You almost convinced people that the Lib Dems and Tories were seperate parties for a while. Until the vote, of course.
Judas!
“Trust special administration (TSA) as it is known, was introduced by Labour in 2009. It is a blunt process that should only ever be used in exceptional circumstances of financial or clinical failure. The principle was welcome, but when I looked closely, I felt the execution left unintended gaps in local accountability and a democratic deficit, and that’s why I took up the issue.”
And yet, unintended gaps and all, the policy still stopped Hunt closing Lewisham.
You’re seriously saying that your new policy has stopped it being closed?
Paul, I note you looked closely at the power of the TSAs.
Did you have time to look closely at the Coalition Agreement?
I bet the private medical companies and private health insurance companies are delighted with this.
This wasn’t a good thing. I’m so disappointed…
Paul says “Also as a result of the changes we have secured TSAs will now have to consult with NHS Trusts and their staff, as well as with commissioners (CCGs) of any affected NHS organisations.”
The problem with this is that several groups are excluded. First and foremost, the patients, but in the post Lansley NHS other groups such as hospital doctors are being marginalised, undermining the need for decision to be based on clinical need. The regional health authorities have been abolished at a time that decisions need to be made on a regional basis. GPs have been given too much power, and there are not enough safeguards against conflicts of interest. Centralised commissioning decision are being made at pace by new bodies staffed by (over?)eager, but inexperienced teams.
When the ‘bedroom tax’ has been watered down, and the changes to student loans have been accepted, the major changes that we supported in the NHS, without public consent, will be seen as the biggest embarassement of our participation in the coalition. It will haunt us for years to come.
We’re consulting…
We’re consulting…
We’re consulting…
We’ve finished consulting, now we’ll close the hospital as we planned at the beginning of the consultation.
I am a little concerned that clause 119 can be seen as a step back from the healthcare reforms earlier in the parliament. Surely it is a restoration of a command and control power to organise health services with a strategic overview, in sharp contrast to the devolution to CCGs etc we saw before.
That is to say it is precisely the sort of thing 38 degrees was calling for a couple of years ago. I expect knee-jerk conservatism from them, but I would hope the government has a clearer philosophy.
Presumably, Joe Otten, you also expect knee-jerk conservatism from local people and groups, and would therefore discourage their involvement?
How ironic it seems that when Hunt was a PPC, in the run-up to the 2005 election, he was in competition with his LibDem opponent to be perceived as ” leading” the campaign to save a local hospital.
Thanks for all your work on this Paul and I understand from a realpolitik point of view why you did what you did in dropping the amendment. I also accept that there is the cross party committee to report in the future which you are to chair.
However.
There are two problems.
First was the issue itself, best illustrated by Jenny Barnes – I can see her scenario as being the real end result – with no firm legal backing consultation will just be window dressing. Second this has gone from a PR win to a PR disaster (rather like tuition fees). We have gone from hero to villain in one easy step.
I was heavily involved in the Save Lewisham Hospital campaign with my colleagues in Greenwich and Lewisham Lib Dems. Ahead of the local elections we need this like a hole in the head. http://853blog.com/2014/03/12/lib-dems-endanger-lewisham-hospital-and-themselves/
I’m wondering how a comment like ‘Judas!’ fits with your comments policy …