Health and Social Care Bill

There has been so much written and spoken about this Bill and so many scare stories publicised that I am becoming increasingly concerned that those who depend on our NHS may start to believe some of the scare stories.

The Government believes in the NHS which is why the Government is guaranteeing it will always provide treatment when you need it regardless of the ability tp pay. Despite the need for the Country to start to live within its means because of the importance of the NHS the Government is increasing the resources available to the NHS. Spending on the NHS is being increased in real terms even though very difficult spending decisions are having to be taken in other departments.

The Bill shifts power to family doctors so they can obtain the best healthcare for their patients. The Bill scraps two layers of administrators ( the Strategic Health Authorities and the Primary Care Trusts) and the money they spend on health care will now go directly to groups of doctors. Doctors will decide how best to spend that money after discussing the matter with other health care professionals like nurses – These groups will be called Clinical Commissioning Groups (CCG’s for short).

Doctors will be able to obtain the healthcare their patients need from the NHS and from other organisations but they must obtain the best treatment – not the cheapest – and the Bill encourages doctors to give their patients more choice. My view is that when someone is ill as long as their doctor is able to obtain the treatment they need to make them better it matters little to them whether that treatment is provided by someone employed directly by the NHS or someone else who is paid for by the NHS. Either way what matters to the patient is they get the best care they can and it is free at the point of need.

The new Bill also seeks to join up provision at a local level. Health and Well Being Boards will be set up which will bring together local healthcare providers from the NHS together with social care providers from the Council and those concerned about public health (in other words those concerned about trying to stop people becoming ill in the first place). All these groups will come together to make sure there is a joined up way of people healthy and making those have fallen ill better.

It is easy to forget that it was the last Labour Government that provided for private companies to provide healthcare for NHS patients. This Bill puts the NHS, not-for-profit organisations, charities and private sector health companies on the same footing.

For the first time the bill places a statutory duty on the NHS to reduce health inequalities. In 2005 the British Medical Journal said ‘The difference between life expectancy of the richest and poorest in our country is now greater than at any time since Queen Victoria’s reign’ and under the last Labour government the gap grew. The new Bill will make it law that the NHS must work together with others ( such as the local councils) to make sure people everywhere get the same level of care.

More information about the action the Government is taking to modernise our NHS can be found here

Published by David Nuttall

Business and Political Consultant

8 thoughts on “Health and Social Care Bill

  1. Well, Mr. Nuttall, vote won – ably assisted by the mendacious chancers in the Lib Dems, who should be even more ashamed than yourself.

  2. Tomorrow, and in less than 24 hours, this unmandated government and its bill will be railroaded through the Lords by a collection of supine LibDem and newly created (plus backwoodsmen) Tory members, all of whom were appointed to the Lords via personal political preferment.

    In other words, this bill will be voted through, in a sham, by people who did not stand before you and me to justify their positions in the Lords and to ask for our popular support and mandate.

    This is, at best, a fairly sick perversion of our political system.

    No-one in May 2010 voted for this bill. It wasn’t even on the map, and the Tories kept quiet about it, knowing they’d never get in on a ‘privatise the NHS’ ticket. It wasn’t in the Coalition agreement. We were promised “no more top down reorganisation of the NHS” by Cameron, and yet that is what this is. And what’s more, Lansley boasts that he worked on this plan for 6 years prior to the 2010 election.

    This is beyond my ability to express contempt for either the Tory or LibDem parties, and even if you are a supporter of either, you should consider carefully the evasive nature of the present government in their efforts to push this bill through. Remember, for example, that having been told twice by the Information Commissioner to release the associated risk register relating to the bill, detailing what problems might come about because of it, they still refuse to do so. It will only be released after the bill is passed via Royal Assent.

    That is not open government. That is evasive and fraudulent government, and Mr. Nuttall should be ashamed at voting for this caricature of democracy.

  3. Incidentally, and lest we forget, the people who will police the new system – the inaptly named Monitor – are hardly beacons of independence and probity.

    “The current government has made two new appointments to Monitor’s board, including the chair, who is also the body’s chief executive. Both were previously senior partners at the consultancy company McKinsey. Of the six members of Monitor’s senior management team, two previously worked for McKinsey (including the chief executive) and two at a similar company, KPMG.

    As an investigation by Spinwatch, carried in the Mail on Sunday, shows, both board members and executives at Monitor have been lavishly entertained by McKinsey, which, like KPMG, is picking up fat contracts from NHS reforms. The company, the Mail reports, drew up many of the proposals in the health and social care bill, which were “included in the legislation wholesale”. Both McKinsey and KPMG have been major beneficiaries of previous privatisations or private finance schemes.”

    It should also be noted that not only has Andrew Lansley’s office received funding to the tune of £21,000 by Care UK ( a private health industry company) in November 2009 (reported by the Telegraph!), but that the saintly LibDems received £400,000 in 2011 alone from Alpha Health Care ( a private health care company).

    Now – would you care to talk about vested interests, David? Because it seems to me that there’s ample evidence of vested interests in the bill – and they’re wait for it to become law, after which it’s out with the Moet et Chandon.

  4. I do think the Conservatives have a credibility problem here. First David Cameron’s pledge not to have a ‘top down’ reorganisation of the NHS. But there is no way what he is now pushing through can be described as anything else but ‘top down’. Second Andrew Lansley’s clear pledge, that you I am sure honestly believed, to prevent the Maternity closure at Fairfield – that has nevertheless happened.
    Pushing the reorganisation through against the clear advice of those I believe know best, namely those who work in the NHS, is a big mistake your party will come to regret.
    Our care when I’ll is not something business should make a profit from. I want to be treated by someone who cares about my health – not their profit.

  5. I paste in here a very sensible sum up of the bill so far- quite different to Mr Chaytor’s misleading summary.

    It is written by Roy Lilley – Health policy analyst.
    His full blog list is here:

    Today’s email suggests what MPs and the lords should be doing with this bill.
    As my elected representative, please vote against this bill, or ensure that it is dropped. It has the support of no NHS staff or professional bodies. It will not reduce red tape and will ensure that more publi subsidy will end up in private pockets.

    Who would vote for this?

    In a surprise move and it has to be said, against the run of play, Parliament (with, by all accounts some shoving from Andy Burnham) has decided to do the decent thing and debate the future of the Health and Social Care Bill. This following the ‘People’s Petition’ inspired by Dr Chand, that attracted over 170,000 signatures.

    What will the MPs do? The Tories will be whipped within an inch of their lives, the Labour opposition will meander down the cul-de-sac of privatisation and the LibDems… Anyone’s guess. If they are true to their principles, they will vote with Labour. Unlikely; they have been told by Cleggy-Boy to forget the Bill and move on.

    Let’s assume there were no party politics involved, no whips, no hubris and no climb-downs. What would they do. Well, I guess they might look at the facts.

    1. The Bill ws intended to put GPs at the heart of commissioning. It doesn’t it is now ‘clinicians’.

    2. The Bill was then intended to let clinicians commission in small groups. It doesn’t; small groups don’t have and can’t recruit the talent to do it and they can’t carry the financial risk of commissioning. Small groups of clinicians (CCGS) are being corralled into Commissioning Support Organisations.

    3. The Bill makes no mention of Commissioning Support Organisations; they are outside the purview of the Bill and the reach of Parliament and will be (in the clear admission of the DH) private or third sector organisations who will use NHS money to arrange commissioning, care-pathways, formularies and referral criteria. They will become the engine room of the NHS.

    4. The Bill makes no provision for the real risk in what happens if a substantial private sector provider goes broke or decides to give up providing services (Remember Southern Cross). This puts the public at risk.

    5. The Bill claims to create choice for patients. It does not. Patients will still have to register with their local GP, who will have to belong to a local CCG, which will be in one of 30 national Commissioning Support Organisations who make every decision about them, without them.

    6. The Bill claims to make the NHS stronger for the future; it doesn’t. It fragments the supply side and denationalises it.

    7. The Bill claims to address the future health needs of the nation. It doesn’t. It won’t make fat people thin or old people remember who they are.

    8. The Bill claims to cut bureaucracy; it does not. Roles have been cut (45%) in pursuit of savings but the jobs still need to be done. The replacement for 3 layers of management is 5 layers of complexity. A text book management error.

    It might be worth mentioning that every professional organisation, Royal College and patient organisation has either asked for the Bill to be withdrawn or opposes it in some way. Even the organisation that set out as enthusiasts the NAPC and the NHS Alliance now express reservations.

    What’s gone wrong? Doing the right thing is what’s gone wrong. The complex Bill, was at the outset, a bad piece of Parliamentary drafting. In doing the right thing, fixing it, complexity has been piled on intricacy and now we have confusion and muddle.

    What’s the right thing to do? The sensible thing? Stop, take stock, see where the NHS is in its present state; in the grip of trying to save one fifth of its budget and keep going against the tide of demand. Properly assess the impact of the consequences of the Bill and if necessary start again.

    The intention of the Bill is to take the politics out of the NHS. A good start would be on Tuesday. Look at the facts not the politics. Who, in their right mind would vote for this?

    Hence my hope that the Bury North MP will be sensible and not support this Bill for the vital interests of the people of Bury North!

  6. David,

    A few facts for you and others here to consider:

    The Royal College of GPs estimates that the number of NHS statutory bodies will rise from 163 to 521. How does that square with ‘reducing bureaucracy’ as often claimed by Lansley?

    Why has the Government appealed against the release of the risk register associated with the bill, despite being order by the Information Commissioner to release it?

    It’s worth reading the views of Professors Allyson Pollock and David Price of University of London writing in January 2012 edition of The Lancet – itself hardly a publication known to scaremonger or give space to ‘socialist workers’ or ‘Trotskyists’ as I believe government ministers have so charmingly referred t those objecting the H&SC bill.

    Click to access Lancet_2012_Pollock_HealthAndSocialCareBill2011.pdf

    I would contend that there are very good reasons to deeply distrust a government that pledged (prior to May 2010) ‘no top down reorganisation of the NHS’, before embarking on the most serious changes to the NHS since its inception in 1946.

    I suggest, David, that if you and the government are so confident that this bill is a Good Thing, that you call a general election and let the British public decide whether they agree or not.


  7. “A TORY politician has vowed to prevent the closure of Fairfield Hospital’s maternity ward if the Conservatives win the next general election.

    MP Andrew Lansley, the Shadow Secretary of State for Health, said he will stop the move “within days” if the Tories come into power, despite work being underway to extend maternity services at the Royal Bolton Hospital.

    Mr Lansley visited Bury to launch a fresh campaign against the relocation of the town’s maternity, neonatal and childrens’ in-patient services, which is due to happen in 2011.”
    Bury Times website, Wednesday 4th November 2009

    Why do you think so-called ‘scare stories’ are so prevalent? Could it be that the scares become reality all too often? Which vows do we believe?

  8. It isn’t reform the public are afraid of, it’s that funds will find their way into the pockets of the raft of advisors like McKinseys and their clients who are lined up to mop up the cash just like Haliburton have in the Iraq war. This is borne out of the inherent distrust of politicians who traditionally go on to work for these businesses when they leave office and are sometimes remunerated by these companies before they leave office. It’s short odds in my book that Andrew Lansley will end up working for one of these firms post-politics. The reforms are supported by my GP and he’s one at the sharp end who should know. Radcliffe has a 2 year old health centre with an MRI suite that hasn’t opened it’s doors because of the funding regime which will hopefully be cured by these reforms – so long as the cash doesn’t drain out of the NHS as many rightly fear looking at how much McKinsey have already earned in constructing a reform bill that is more theirs than the governments. Until the liberals are ditched, this government lacks credibility under an increasingly weak looking PM.

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