NHS activists have embroidered handkerchiefs for the 72 most marginal English MPs with the message:
“Don’t Blow It! Kill the Health and Care Bill before it kills us”
We Own It, Calderdale and Kirklees 999 Call for the NHS, and other campaign groups in the marginal constituencies will be delivering the handkerchiefs to the MPs, along with a letter signed by constituents that urges them to vote down the much-criticised Bill that will accelerate the privatisation and destruction of the NHS.
Here’s where you can check if your MP is on the list, and if they are, please sign the Don’t Blow It! letter.
The aim is to show MPs who have the most to lose – their seats in the House of Commons – that the public won’t stand for dismantling the NHS.
Mary Whitby, Don’t Blow It! campaigner in Lancashire said,
“If our elected politicians don’t oppose US-style Integrated Care Systems, they will pay heavily at the ballot box while ICS managers get away with their big bonuses and knighthoods.”
The Health and Care Bill must be stopped
We believe the Bill must be stopped as it is not fit for purpose and NHS and social care legislation must be deferred until a Bill can be drafted that will enable:
- world class health care for all
- a publicly-provided National Health Service, adequately funded and free at the point of need
- providing comprehensive treatments based on the patient’s best interest, decided together with clinicians not on the basis of financial calculations
- with national NHS staff pay and conditions and professions regulated independently of government politics.
We do not believe the Bill can be amended in a way that will enable any of the above. This is for the following reasons:
The Bill is bad for patients
The Bill reduces the government’s obligations to secure NHS care for us all in clause 15, 16 and 18.
By reducing the government’s obligations to secure NHS care for us all, the Bill:
- Could result in whole areas without hospital medical services, opthalmic services or the provision of emergency services for everyone present in the commissioner’s area. (As a result of public outrage, the Public Bill Committee has amended this Clause in the Bill to clarify that statutory Integrated Care Boards do have the responsibility to provide hospital medical services and opthalmic services in their area).
- Would entitle providers of services to have: “discretions… in relation to anything to be provided” by them.
The Bill also risks restricting patients’ access to care on the basis of actuarial considerations, as a consequence of the tight financial controls it hands to Integrated Care Boards ((HC Bill Part 1, section 23,3), combined with risk/reward share contracting that makes providers carry the burden of any “overspending”.
In this way, the Bill will force people to go without the treatment they need, or to pay for healthcare if they can afford it more than they already do.
The Bill is bad for NHS staff
The Bill would worsen the current NHS front line staff shortage – currently amounting to 40,000 full-time equivalent nurses and 49,000 full-time equivalent doctors and doctors in training in England across primary and secondary care.
This is because it would make the professions less attractive by undermining already poor working conditions and pay – it would:
- Threaten national agreements on wages, terms and conditions of employment by putting pay agreements under the control of Integrated Care Systems.
- Allow for the introduction of un-regulated workers such as physician and nursing associates, and require that health care professionals are regulated in a ‘cost efficient manner’, as outlined in the White Paper on page 63 and 64. Regulatory bodies currently operate autonomously from the Government.
- Introduce flexible staff redeployment across NHS organisations, based on “learning” from redeployment of nurses and doctors during the Covid-19 pandemic. This means staff working outside their trained competences; suddenly being parachuted into teams they are unfamiliar with, which makes their work far more difficult and less safe for patients; and having to travel to different places to work for other providers
In this way, the Bill seems set to perpetuate the moral distress and moral injury to NHS staff that occurred during the pandemic, with risks to life and mental and moral wellbeing.
A Bill for big business
Huge global companies are driving the formation of the 42 ‘shadow’ Integrated Care Systems. They are remaking the NHS in the image of their own systems, developed for the US ‘managed’ health care market which cuts costs by restricting patients’ access to care , deprofessionalising clinical staff through the imposition of tick box diagnostic processes and introducing clinical staff such as physician and nursing associates without professional regulation and competencies.
These companies will be entrenched in the NHS by the Health and Care Bill’s imposition of a “duty to integrate” (Clause 19), and its creation of a power to “create a separate procurement regime…, removing the procurement of health care services from the scope of the Public Contracts Regulations 2015 and repealing Section 75 of the 2012 Act and the National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013.” (Health and Care Bill Explanatory Notes, 114, p 29)
There is nothing in the Bill to stop these and other companies from being members of the new statutory Integrated Care Boards, which will:
- Decide which health services are provided in a local area (and which are not).
- Be allowed to award contracts for clinical care to private healthcare providers without considering other bids – enabling further privatisation and cronyism.
This not only puts taxpayers’ money in the pockets of shareholders – it gives private companies a say in how public money is spent in the future.
The spin by both government and by Labour Party MPs such as Karen Smyth – a member of the Public Bill Committee – that the Bill represents the end of the era of marketisation, could not be further from the truth.
The Bill will do nothing to solve the NHS’s problems
A recent systematic analysis of evidence concluded:
“In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers.”
Help make parliamentary history
Governments have been defeated on amendments and motions before – but not on whole Bills, we think.
The Don’t Blow It! action is just one part of a campaign across the country to stop the Bill.
This is a populist government – it does what it thinks it can get away with. We are confident that with enough public outcry, the Government will back down as it has on so many issues.
It must be the first NHS and social care bill that the Health Secretary of the time doesn’t want.
And the Health Service Journal recently reported that most backbench Conservative MPs don’t know what it’s about. When marginal MPs find out, they might not be too keen to be associated with it, if there’s enough pressure from constituents.
To find out how to take part in the action, email Calderdale and Kirklees 999 Call for the NHS at firstname.lastname@example.org