Thursday, 28 February 2013

An Open Letter to Parliament

On Sunday 24th Feb I was discussing with colleagues about the latest attempt by the coalition to force privatisation of NHS services on local commissioners. I had an idea to gather names for an open letter to publish in the press and exert further pressure on both Houses of Parliament.

Little did I know that in 48 hours I would collect over 1000 names prepared to sign the letter (below) ranging from nurses, doctors, porters to Professors and senior consultants - staff from across the whole spectrum of the NHS. I wasn't surprised in a way because the NHS engenders such a feeling of support from the whole country and the wish to prevent it from being sold off to the commercial sector is huge.

I hope the Department of Health, Jeremy Hunt, David Cameron and Nick Clegg take heed of this huge groundswell of opinion that we do not wish our NHS to be sold off to the commercial sector. We did NOT vote for this at the last General Election and democracy must be seen to prevail.

The Daily Telegraph printed the letter along with the 1000 plus names on Friday 1st March 2013 and also a story ran on the piece that same day.

In subsequent days there was much discussion about this huge show of concern by doctors, patients and NHS workers and the coalition began urgent talks on how to deal with this latest problem in marketising our NHS. An influential body called the Academy of Medical Royal Colleges wrote a letter to Lord Howe which leaked and the letter expressed serious concerns over this latest move by the coalition.

Unfortunately the Academy had not been quite as forthright during the Health Bill passage through Parliament when it was quite clear to the vast majority of the population that the Health Bill would lead us to where we are now - on the verge of selling off many NHS assets. The Academy undertook an embarrassing u-turn in February 2012 after pressure was exerted by Mr Lansley et al leading them to issue a very bland statement which in effect helped the Health Bill become law.

We must maintain the utmost pressure on all policy makers and medical leaders to continue to oppose the Health Act and subsequent secondary legislation which will continue to sell of parts of our English NHS to the commercial sector.

Please consider writing to your MP as letters to them really do make a difference - you can find out who they are and how to contact them here. Feel free to use any of the information here or a previous blog of mine when you write to them.


This is how I sought signatories to the letter which can also be found below

Dear all,
Another damaging step is about to occur to our English NHS.
To highlight this I intend to send the open letter which is below to a national newspaper. Please read and then sign your details if you are happy with it.
I am intending to gather as many signatures for this open letter and then send it to a major daily newspaper but I need to do this VERY QUICKLY. Therefore please send this link far and wide to anyone who works in the NHS.
Newspapers always need certain information and not just a name. Therefore I am asking for your name, job title, location and address and a daytime telephone number. I give you my ABSOLUTE GUARANTEE I will not release anything apart from your name job title and location. So in the newspaper mine would look like this Dr David Wrigley, GP, Lancashire.
Many thanks and below is the letter I intend to send.
DEADLINE is WED 27th Feb midday.
More information can be found HERE

Dear Sir/Madam,
We write as doctors and healthcare workers who are worried about the latest attempt by the government to irreparably damage our NHS. The government has just laid secondary legislation (under Section 75 of the Health & Social Care Act) to force virtually every part of the English NHS to be opened up to *compulsory* competitive markets, open to the private sector to bid for NHS contracts. In just over a month these regulations will be law.
Parliament does not normally even debate or vote on this type of regulation – but it is possible. Even those Lib Dems who supported the Health & Social Care Act should be very concerned as the regulations break the reassurances offered by the Government to both Houses of Parliament, to local Clinical Commissioning Groups and to the English electorate that the Act allowed local choice about when to use competition. But these new regulations do not allow local freedom to decide when to use competition in the provision of our healthcare.
These regulations were laid down on 13th February and will become law on 1 April unless MPs first insist on a debate and then vote them down.
The campaigning group 38 Degrees has launched an urgent petition and we urge Parliamentarians to force a debate to discuss and vote on this issue, which is a further nail in the coffin of a publicly provided NHS, free from the motive of corporate profit allowing it to concentrate on patient care first and foremost.

Sunday, 24 February 2013

Section 75

Urgent, immediate action required please
Secondary legislation under Section 75 of the Health and Social Care Act 2012
We have only learned this morning that the deadline for writing to the clerk mentioned below is tomorrow Monday 25th February so please write NOW if you can. We would be grateful if you also ask your friends and contacts to do the same.
The essential message is at the foot of this e-mail
• On 13th February 2013 the Government published the regulations (SI 257) under Section 75 of the  Health and Social Care Act 2012
• Assurances were given by ministers during the passage of the Bill through Parliament that it did not mean the privatisation of the NHS, that local people would have the final say in who provided their NHS.
• The regulations just published break these promises by creating requirements for virtually all commissioning done by the National Commissioning Board (NCB) and Clinical Commissioning Groups (CCGs) to be carried out through competitive markets, which will have the effect of forcing through privatisation regardless of the will of local people. They contain legal powers for Monitor to enforce the privatisation spontaneously or at the request of private companies that lost bids.
• They would also make it impossible to fulfil some of the key thrust of the Francis report recommendations.
This Statutory Instrument (SI) will be going to the Lords Secondary Legislation Scrutiny Committee on 5th March; this Committee will then report to the House. If people contact the Clerk of the Committee to emphasise its importance it will encourage them to look seriously at the Secondary Legislation and then hopefully report it to the House as meriting special attention. This in turn helps the tone of the debate on the SI.
According to HSJ, "Lawyers working in the NHS told HSJ the regulations could have wide-reaching implications on the mix of providers of NHS-funded services. The rules ban “any restrictions on competition that are not necessary”. They say contracts can only be awarded without tender for “technical reasons, or reasons connected with the protection of exclusive rights” or for “reasons of extreme urgency”."

-------- Original Message --------
Subject:Secondary legislation under Section 75 of the Health and Social Care Act 2012
Date:Sun, 24 Feb 2013 16:29:41 +0000

Dear Sir / Madam,

Secondary legislation under Section 75 of the Health and Social Care Act 

I understand that the Lords' Secondary Legislation Scrutiny Committee 
will be discussing the regulations laid by the Government under Section 
75 of the new NHS Act (1) at their meeting on 5 March.

I should like to draw to your attention the radical nature of these 
regulations. During the passage of the Health and Social Care Act 
through Parliament ministers constantly reassured us that there was no 
possibility of NHS services being forced into 'the market', and that the 
health regulator Monitor would not have powers to enforce such a change. 
It followed that the NHS would not therefore be subject to EU 
competition law, and thus no irrevocable change was being made to its 

However, examination of the new regulations reveals that local 
commissioners, the new Clinical Commissioning Groups, will have no power 
to resist Monitor's demands, will be less able to introduce quality 
criteria, in addition to cost criteria, into the contracts they are 
required to let, and will have less opportunity to consult local people 
about their plans.

Since this is in direct contravention of what was said to Parliament, I 
hope you will be able to ensure their Lordships know that these 
regulations merit special attention and are not simply implemented 
without contradiction and change.

Yours faithfully,

(1) The National Health Service (Procurement, Patient Choice and 
Competition) Regulations 2013) made under Section 75 of the Health & 
Social Care Act 2012) [2]


Tuesday, 5 February 2013

Roll up! Roll up! The NHS sale continues...

CCGs are at the forefront of the huge NHS reorganisation that we were told by David Cameron would never happen under his watch.

There are three letters on the lips of everyone closely associated with CCGs at the moment - these three letters are CSU. These letters stand for Commissioning Support Units and you would be forgiven for not having heard much about them as they are quietly getting on with the job they have been tasked to do by the huge behemoth that is the National Commissioning Board.

CSUs have been set up and separate ones are running in every part of the English NHS. They were first described in late 2011 but not a great deal has been said about them, however it is vital we let more people know about them.

CCGs have been tasked to provide healthcare for local communities on an absolute pittance of a budget compared to what PCTs used to have available to spend on patients.

First mooted by the Dept of Health in late 2011 when the Health Bill was seeing more and more opposition CSUs were designed to provide 'support' to CCGs. This is a calculated move by the Dept of Health and National Commissioning Board - they always knew this 'outside' help would be needed for CCGs.

CSUs are well and truly in place now and are fully staffed - often with PCT staff who have moved on from their previous job. The CSUs provide vital back office support to CCGs on issues such as human resources, pay roll issues, patient engagement and more significantly provide help with major issues such as service redesign.

Now here is the nub of the issue and one which is a further example of the English NHS sell off we see all around us - the original document mentioned the fact these CSUs would be 'outsourced' by 2015. This of course means that they will set up their organisation, take on significant roles in locality commissioning and then they will be sold off to the private sector in 2015.

The CSU guidance can be found here and it screams of being made ready for sale to the highest bidder. Much talk of 'customers' and using the 'independent sector' - things you are more likely to hear in a Tesco management document rather than an NHS one.

It is another shocking example of how the NHS is being transformed into a saleable commodity - it is being fattened up ready for sale at the market! Once the City and management consultants get a grip on CSUs they will have control of a very influential part of the NHS that provides care for patients. It is well evidenced that introducing private companies into health care systems increases cost and reduces efficiency. Companies have to make profits to please their shareholders and directors. These profits could be reinvested in patient care or more nurses for example.

It is a shocking prospect and we should be lobbying MPs and policy makers to say this CSU sell off is wrong. It should not happen and we need a political commitment that CSUs will remain within the NHS and within the public sector.