Quick guide to section 75

For a brief overview of the regulations and context, we publish here a short note from Lucy Reynolds. We published the full story on section 75 here

The regulations apply the competition law regime to the arrangement of all NHS services, with very rare exceptions where to do so would be impossible.  

Competition law is a set of laws to manage markets.  Because competition law was designed by commerce for commerce, the parts of it which cover public services are very pro-private enterprise. The forcing of competition law on all NHS spending through the implementation and enforcement of these regulations will have the effect of helping the private sector to cherry-pick the services where it can make most money, thus destabilising the finances of those of our traditional NHS hospitals which are not already on their knees financially because of PFI because the public sector providers will be left with all the difficult cases, which are by far the most costly. 

The government will then have an excuse to do all over the country what it is doing in South-East London: shutting well-functioning services which are working at full capacity, replacing A&Es with first-aid posts ("Urgent Care Centres" which have already been responsible for avoidable deaths), selling off the land on which hospitals stand, and outsourcing services to the private sector through tendering them out on long contracts.

All this is completely unnecessary.  While Sweden and the Netherlands are reporting soaring system costs and loss of access to services for the poor due to the implementation of competition law rules following their recent health service privatisations, Canada has successfully protected its affordable comprehensive universal system of care. It did this by declaring that it will be run as a public service, and not in such a manner as to be able to make profits from it.  Scotland and Wales reversed the NHS market reforms in 2004, and subsequently saw healthcare outcomes improve and costs reduce as they saved the extra costs of running the market and were freed from the distortions to care choices that it introduces. We too should now eject the market from the NHS and claim the public health service exemption in the interests of keeping a national health service that serves us not its new owners

About the author

Lucy Reynolds is a research fellow at the London School of Hygiene and Tropical Medicine.