In the post-Lansley NHS the Secretary of State for Health no longer has the duty to provide a comprehensive health service. Such responsibility as remains has been handed to the Clinical Commissioning Groups (CCGs). CCGs do not have a responsibility for everyone in the neighbourhood – there is no universal state responsibility to provide us with healthcare any more – but they do at least have the responsibility for commissioning the care needed by their own registered patients.
The Clinical Commissioning Groups are about to be undermined.
When Jeremy Hunt, the current Secretary of State for Health called in a special administrator to the South London Healthcare Trust he hoped that he would be able to put off their financial collapse at least until he was no longer the Secretary of State. The Administrator came up with the plan to close services at the well run neighbouring Lewisham Hospital and transfer them – and the money that went with them – to shore up the shaky finances at South London. Not surprisingly patients and doctors at Lewisham objected. The Clinical Commissioning Group in Lewisham believed that it was in their patients’ interests to continue the services at Lewisham Hospital and that what Jeremy Hunt was attempting to do was illegal.The courts supported them.
Jeremy Hunt’s response has been to attempt to change the law. He has added a clause to a Care Bill already before Parliament. If this clause is passed, then Trust Special Administrators will have the power to reconfigure – ie, close – healthcare services not only at the NHS Hospital Trust that they have been called in to sort out, but at any other healthcare facilities in the neighbourhood. And they will be able to do so without real public consultation (just one meeting will suffice).
If the clause is passed Trust Special Administrators will be able to take services away from hospitals that are currently running perfectly well, that are serving their neighbourhoods and are in a strong financial position.
As almost half the hospital trusts in the country are facing financial difficulties, we must assume that every hospital in the country could find itself under the scrutiny of a Trust Special Administrator, either due to its own struggles or those of its neighbour.
If services are moved around to suit the financial convenience of these Administrators it will become quite impossible for Clinical Commissioning Groups to decide what services they wish to commission and from where these services should be delivered.
The Clinical Commissioning Groups will be impotent. They will not be able to serve their patients’ needs.
It is very important that this clause 118 of the Care Bill is defeated.
The Lib Dem MPs and Peers ‘helped’ the Tories to pass the unwarranted ‘Top Down’ reorganisation of the NHS. They now have a golden chance to make some amends by ensuring that clause 118, as currently drafted, is defeated.
* Suresh Chauhan is a former Liberal Party member from Leicester, who has been campaigning against the NHS Bill since July 2010.
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3 Comments
Is this the story about the better of two hospitals having to close because of one of Labour’s PFI contracts?
And if there is currently no power to reconfigure services across CCG borders, then surely this is an omission that needs correcting, whatever the rights and wrongs of this case.
Yes, just restore the duty of the Secretary of State to provide the service and balance the books. And Joe is right: Labour forced PFIs on nearly every Hospital Trust when the money needed could have been borrowed much more cheaply via the Treasury. Criminally dishonest. My local NHS Trust has an excellent record for patient care, but it’s in ‘special measures’ because it has to pay £30millions a year for 30 years to a PFI largely owned by offshore investement houses and other tax avoiders.
When the NHS was set up, Herbert Morrison, hardly a Liberal, argued for services to be under local democratic control as far as possible. Aneurin Bevan, imbued with the spirit of wartime top-down planning, succeeded in separating the NHS from social services and other local authority services. From that mistake messes like the current one derive.