Brexit isn't the only thing parliament needs to demand a vote on right now - the NHS is too

In January, Jeremy Hunt will attempt to sneak through secondary regulations, without parliamentary debate, what some have called the ‘biggest change to the NHS since its creation. Do enough MPs care enough to stop him?

Ellen Lees
14 December 2017

Jeremy Hunt is trying to sneak through legal changes that will fundamentally change the NHS - with no scrutiny and no debate.

So, no surprise there.

The next step for Jeremy Hunt’s plans to overhaul the NHS is the introduction of Accountable Care Organisations (ACOs). ACOs are the latest incarnation of other controversial NHS plans that have been cooked up since Cameron’s infamous 2012 Health & Social Care Act meant the government had less responsibility to secure comprehensive, universal healthcare. Leading campaigners, doctors and journalists have scrutinised these latest plans and found them both vague and alarming. In the words of this site’s editor, these so-called Accountable Care Organisations “aren’t accountable, and they don’t really care”.

The ACOs (which aren’t, legally, accountable public/NHS organisations) are being “put in charge of allocating resources”, according to leading health campaigner Professor Allyson Pollock – with private ‘partners’ having larger contracts and more and more of a role in decision making, it seems. Kailash Chand of the BMA has also said ACOs are a ‘trojan horse’ for privatisation – particularly as they talk of ‘integrating’ payment systems for both health and social care without addressing the fact that social care has already been mostly privatised. Chand has also warned that GPs “will no longer be independent advocates for their patients” under this new system of outsourced decision making.

We now know that Hunt plans to change 10 pieces of secondary legislation to make it possible to create ACOs. The shape of these legal changes will inform what ACOs look like, and whether they are indeed accountable, or if they will pave the way for mass privatisation of NHS services.

There is no current plan to allow MPs to debate these changes in Parliament. Jeremy Hunt plans to push these changes through with absolutely no scrutiny from MPs.

We need MPs to scrutinise ACOs because of the potential they have to damage the NHS. Some have suggested that there may be a way to introduce ACOs in a way that doesn’t encourage or allow privatisation, and which integrates primary and secondary NHS services. But the evidence is scanty – and there is the sizeable risk that ACOs will be vehicles for large scale privatisation by healthcare organisations like Kaiser Permanente. They are, after all, based on an American system of healthcare organisation – and Michael Moore’s devastating film Sicko exposed how ‘Accountable Care’ in the US means denial of care, and how ‘prevention’ means making it hard for patients to access hospitals.

So, it couldn’t be more important that MPs get a say in how ACOs are implemented.

Jonathan Ashworth has tabled EDM 660 to gather support in Parliament from MPs for a debate on ACOs. He has written to Andrea Leadsom, the leader of the House of Commons, to ask her to call a debate. At the time of writing, 59 MPs have signed EDM 660, but we need many more.

We’ve set up a tool to let you email your MP and ask them to sign the EDM. Over 8,000 emails have been sent so far, and nearly every MP has received at least one email, but more pressure is needed! Take action here by entering your postcode.

The more MPs sign EDM 660, the more pressure will be put on the leader of the House of Commons to allow a debate. This EDM is different to most, in that it can be signed by ministers and shadow ministers. Usually ministers stay away from EDMs, but this one was tabled by Jeremy Corbyn and members of his shadow cabinet team, so all MPs are encouraged to sign.

It’s not exclusive to Labour MPs either! SNP MPs have signed (even though ACOs are unlikely to directly affect the Scottish NHS, they may well affect it indirectly) as has Green MP Caroline Lucas. Conservative MPs are unlikely to sign an EDM sponsored by the leader of the opposition, although some with a regard for due process might be able to sign it... Regardless, Conservative MPs should certainly be encouraged to write to Andrea Leadsom and ask for a debate. They will be much more influential than letters from Labour MPs.

Are Conservatives interested in ensuring that Parliament gets a say on the future of the NHS?

This is urgent – we’ve only got a few days to make sure MPs get a say on the future of the NHS. The changes are set to go through in January, and with the Christmas holidays on the horizon, Parliament is running out of time to schedule a debate. Email your MP now.

Additional reporting by Caroline Molloy

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