Stormy scenes are likely in parliament today as the government tries to “rush through” changes that will make it far easier to close hospitals without public consultation. The changes,which OurNHS has campaigned on from the start, now face fierce opposition from doctors, 38 Degrees, the British Medical Association, NHS campaigners and charities.
On Friday Ed Miliband tabled a motion of opposition to the Bill, saying it “includes provisions which could put NHS hospitals at risk of having services reconfigured without adequate consultation and without clinical support”.
Jeremy Hunt’s revealed his likely line of attack over the weekend when he tweeted that it was “shocking Labour not supporting measures in the Care Bill that will prevent another mid-Staffs. Have they learnt nothing?”
But the Labour motion also highlights that the Bill does not implement the recommendations of the Francis Report into mid Staffordshire, and also fails to meet earlier promises to cap the cost of social care at £72,000.
And Hunt’s tweet prompted Dr David Nicholl, consultant neurologist and Royal College of Physicians Council member, to reply “That is frankly the most ill informed tweet from a Secretary of State in Health I've ever read. Your amendment is toxic.” The Royal College of Physicians has previously said that “handing powers to special administrators to make decisions about neighbouring trusts is cause for concern.” The UK already has fewer hospital beds than most developed countries. Concerns that Dr Nicholl raised in a letter to his MP were met with assurances from Earl Howe that dodged the issues.
The British Medical Association has also come out against the hospital closure clause, saying it would allow the Health Secretary to "force changes through the back door".
The hospital closure clause gives Trust Special Administrators greater powers including the power to make changes in neighbouring trusts without consultation. It was added to the Care Bill just as the government was being defeated by Lewisham Hospital campaigners, in an attempt to ensure that campaigners could not challenge such closure plans in the future. But the new Bill could be applied anywhere in the country.
Louise Irvine, Chair of the Save Lewisham Hospital campaign, said “If services need redesigning the law must ensure this is with proper and extensive consultation with local people. This process cannot be rushed. Decisions should not be based on the needs of investment banks. What happened to the government promises that in the NHS there would be ‘no decision about me, without me’?”
Head of the BMA Mark Porter added "As we saw with Lewisham Hospital any attempt to use the failure of a hospital to force through change at neighbouring trusts can result in unnecessary strain on services, patient uncertainty and a huge cost to the taxpayer.”
Writing in the British Medical Journal, Professor Allyson Pollock says that the clause will "undermine equal access to care in England" and removes "checks and balances designed to ensure that changes are in the interests of the communities affected" with Trust Special Administrators only having to think about money.
The NHS Alliance (an influential umbrella group of NHS managers) says that the clause is "a threat to the NHS in general and accountability in particular".
Clive Peedell, leader of the National Health Action Party, has criticised the clause as a "sinister" attempt to close down hospitals.
Age UK has also criticised the wider provisions in the Care Bill of which this clause is part, saying that the proposed system for dealing with social care is “less generous than originally hoped” and that idea people would be protected against all costs is a “myth”. Some disability campaigners have also highlighted that the Care Bill won't meet the rising costs and inadequate social care that they receive.
Labour released today figures showing that pensioners will have to foot costs of social care of £150,000 or even up to £500,000 in some parts of the country before costs are met under the Bill, contrary to earlier promises of a £72,000 cap.
This is because - as Care Minister Norman Lamb admitted on ITV this morning - the Government cap on care "does not include the cost of board and lodging" of residents living in care homes.
Attempts to defeat the Care Bill in its entirety at second reading may be difficult, given the Coalition majority. No Lib Dems have signed the Labour/Green Early Day Motion which was the first parliamentary attempt to raise concerns about the hospital closure clause. But campaigners think an outcry now could force the government to amend the worst aspects of the Bill - including the hospital closure clause - in its final stages in January and February next year. MPs in marginal seats are already vulnerable on the NHS, polls show.
The Care Bill, including Clause 118 (the hospital closure clause) will be debated from 3pm today in the Commons.
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