URGENT NHS BILL UPDATE
Open Letter regarding the NHS Health and Care Bill From Save Our NHS in Kent (SONIK)
This letter will be circulated to all Kent and Medway MPs, KCC and Medway councillors, local press, the board of Kent and Medway CCG, and the boards of the five Kent and Medway trusts (Maidstone and Tunbridge Wells, KMPT, East Kent Hospitals University Foundation Trusts, Medway Maritime NHS Trust, Dartford and Gravesham NHS Trust).
We call on you to reject the NHS Heath and Care Bill.
During the bill’s passage through the House of Lords in recent weeks, Natalie Bennett (Baroness Bennett) was a lone voice amongst the peers arguing that the bill, even with amendments, does not preserve the NHS’s ability to adhere to its most fundamental duties. She said:
“The Bill is still not in the interests of the public or indeed of the NHS itself as a comprehensive, universal public service”.
Lord Syed Kamall, who has been responsible for steering the bill through House of Lords, has during his lifetime dedicated large amounts of energy to free market lobbying organisations1 that question whether the NHS should exist, whether it should be publicly owned, whether it deserves to get government funding, and that question the principle of a free NHS service (free at the point of use). These organisations (that he has been an active participant in) are suspected of being funded by the private heath industry in the US, but this cannot be proven because the organisations refuse to disclose who funds them.
Save Our NHS in Kent (SONIK) have numerous concerns about the way in which the bill potentially allows private sector interests into the heart of NHS decision-making. Another concern is that the restructure allows certain responsibilities to be dropped, with no one body in the new framework having a clear remit.
There are fundamental requirements that the bill doesn’t explicitly address, and we implore those with political and/or statutory powers in Kent and Medway to ensure that these crucial requirements be preserved – either by calling for the bill to be rejected outright, or by insisting that these needs are written into any new constitution or devised by the ICS.
- The NHS in Kent and Medway must be comprehensive, universal, free at the point of use and based on patients’ clinical needs – not on the Integrated Care Board’s financial considerations.
- The NHS in Kent and Medway must be safely staffed in all service areas, employing all frontline and clinical staff on the basis of national terms and conditions, as in Agenda for Change. All NHS professions should be regulated. Further, the NHS in Kent and Medway should not require ‘passporting’ of staff between places of work where they will have to work with unfamiliar teams. And will not subject staff to further moral injury such as they suffered during successive waves of the Covid-19 pandemic.
- The NHS in Kent and Medway must make sure that primary care providers are treated in the same way as NHS Trusts, when the new statutory Integrated Care Boards prepare their five-year work plans and their capital plans. And it should make sure there is continuity of patient care in GP practices.
- The NHS in Kent and Medway must halt and reverse NHS privatisation and make sure that the statutory Integrated Care Board commissions NHS organisations – not private companies or charities and third sector organisations – to provide NHS services.
Here is an outline of SONIK’s concerns regarding the NHS Health and Care Bill.
1. Integrated Care Boards and Provider Collaboratives
We are concerned about the role of Integrated Care Boards. It is not clear what commissioning functions and powers the Provider Collaboratives (that are an offshoot of the ICBs) will have. A provider collaborative director in West Yorkshire, Lucy Cole, blogged “The new Health and Care Bill recognises provider collaboratives as a key system component.” We are concerned that Provider Collaboratives will be unaccountable to the public, and unaccountable even to the government. We are concerned that they will be making budget allocation decisions regarding NHS services, and that private companies will sit on these Provider Collaborative boards. It is important to be aware that the only part of the NHS that currently uses the Provider Collaborative model is mental health provision – an area which underperforms and where the structuring of services lets down its patients in a shocking way.
It is imperative that the Kent and Medway ICS (Integrated Care System) does not appoint private providers to the statutory Integrated Care Board and its committees or to Provider Collaboratives, and we believe that the Constitution should clarify that ‘private providers’ include APMS GP contract holders, since large companies, such as Modality and the Centene subsidiary Operose Health, hold multiple GP contracts.
2. The NHS must be put before the private health sector
SONIK believes that NHS providers should not be allowed to advertise private providers or direct patients to private providers, either in its premises or within communications, apps or websites – something that is in fact already happening on East Kent hospital Trust’s website2.
SONIK believes that The Kent and Medway statutory Integrated Care Board and its “place” (local authority area) commissioning committees should prefer NHS providers and give them priority over private companies when awarding contracts.
SONIK believes that these fundamental requirements must be preserved and we fear that the NHS Health and Care Bill will erode them.
- The NHS must be comprehensive, universal, free at the point of use and based on meeting patients’ clinical needs – not on the statutory Integrated Care Board’s financial considerations.
- The NHS must be safely staffed in all service areas, employing all frontline and clinical staff on the basis of national terms and conditions, as in Agenda for Change. All NHS professions must be regulated. Further, the Integrated Care Systems must not require ‘passporting’ of staff between places of work where they will have to work with unfamiliar teams. And will not subject staff to further moral injury such as they suffered during successive waves of the Covid-19 pandemic.
- The NHS must make sure that primary care providers are treated in the same way as NHS Trusts, in the preparation of statutory Integrated Care Board five-year work plans and their capital plans. And make sure there is continuity of patient care in GP plans and their capital plans. And make sure there is continuity of patient care in GP practices.
- The NHS must halt and reverse NHS privatisation. Specifically by statutory Integrated Care Boards (and any of its delegated committees with commissioning powers and functions) making the NHS the preferred provider when awarding contracts. The NHS should ban from membership of the statutory Integrated Care Board (and any of its delegated committees with commissioning powers and functions) anyone employed by or a member of a private company, APMS GP contract holder, or third sector company or charity.
None of the House of Lords amendments that have been passed are sufficient to deal with these concerns.
The House of Lords Amendments to the NHS Health and Care Bill are returning to the House of Commons on 30th March 2022. We urge MPs to vote against it, we urge councillors to call on their MPs to vote against it, and we call on NHS decision makers to mitigate the worst of the bill’s impacts when and if changes are implemented.
Save Our NHS in Kent
1 The organisations referred to are the IEA and the Freedom Association. The Freedom Association has published articles such as ‘NHS: National Horror Story; the NHS is funding a scandalous shambles argues the Rev Dr Peter Mullen’ (March 2018); ‘It is time for politicians to be open minded and look at the alternatives to the NHS’ (January 2018); and ‘What will it take for us to have a real debate about how it is funded?’ in which Dr Timothy Tompkinson argues that health services free at the point of use are a bad idea by deploying this ill-fitting analogy: “If your local butcher decided to give away free sausages, he would soon run out..the more free at the point of use services you offer, the greater the demands’ and laments that ‘the majority of the public refuses to countenance a different way of providing mainly free at the point of use healthcare’. The IEA (Institute for Economic Affairs) is notorious for being caught on tape offering US donors access to UK government ministers, for refusing to disclose who funds their free-market propaganda – despite some donors being leaked (British American Tobacco, Philip Morris International and Japan Tobacco International). Funding to the IEA from the alcohol industry, food industry, and sugar industry has also been documented. Statements from the IEA include “The NHS is the country’s most overrated institution” (Niemietz); “It’s time to overhaul the NHS and replace it” (Andrews) and articles such as ‘How the NHS hurts the poor’ (Whyte, 2018) and ‘Motion: this house would privatise the NHS’ (Niemietz, 2016).
2. An advert asking the question “Do you have medical insurance or the wish to pay for your treatment?” already appears on EKHUFT’s website. It is an advert for Spencer Private Hospitals. http://www.ekhuft.nhs.uk/patients-and-visitors/services. The web pages for hospital departments on the http://www.nhs.uk domain have started to acquire orange ‘compare wait times to receive treatment sooner’ buttons next to waiting time notices that say, for example. ‘Up to 60 weeks for 9/10 patients’. If you click the buttons, they currently go to blank pages, but will those blank pages be filled with private providers once the bill is passed? Examples: https://www.nhs.uk/Services/ hospitals/Services/Service/DefaultView.aspx?id=89092 or https://www.nhs.uk/Services/hospitals/ Services/Service/DefaultView.aspx?id=343760 [Departments and Services tab]. SONIK also have screenshots.