Posts Tagged ‘health and social care bill’

This government is driven by venal self-interest

12/03/2012, 04:03:25 PM

by Amanda Ramsay

It’s a very strange time in parliament at the moment. Having changed the legislative calendar, with the Queen’s Speech now in May rather than the traditional November, parliament has run-out of business. The Commons is becalmed while the battles over health, welfare and legal aid being fought-out in the Lords.

With welfare reform cuts about to hit home and housing benefit caps forcing displacement and homelessness, the character of the laws due royal assent over the next few weeks show an old school Tory, right-wing, ideological intent to take government back to laissez-faire sink-or-swim economics; where the state sits back and does the very bare minimum to assist its citizens in trouble.

Whilst Labour souls worry about the Tory-led government’s woeful destruction of aspiration and hope, it is difficult to detect any noticeable or natural empathy from the likes of independently wealthy Cameron and Clegg and the many other millionaires in the cabinet.

Those with private wealth don’t usually know the fear of facing homelessness or joblessness. They can pay for private health insurance and secure their futures through top-class public schooling; can afford private care if disabled, frail or ill and enjoy their own pensions and investments, so have no need for the welfare state. As Tory grandee Alan Clarke once memorably explained, they live off the interest on the interest. Put simply, they can cut with impunity because they don’t feel the pain.

No clearer is this ambivalence evident than with the Health and Social Care Bill. The ramifications of allowing foundation hospitals to use up to 49% of their resources for private, non-NHS work, may not worry certain individuals that can afford US-style private health care insurance, however, NHS waiting lists will surely soar while paving the way for a two-tier health care system.


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Whip’s Notebook: Top down NHS reorganisations, Hulk Hogan and Oliver Letwin

05/03/2012, 07:00:22 AM

by Jon Ashworth

Last week the leader of the House of Commons and lord privy seal Sir George Young (who by the way reads my posts for Labour Uncut or at least his special advisers do and then lets him know if I say anything interesting) announced the likely date for the Queens Speech.

Get your diaries out because the next Gracious Address is set to be May 9th. It didn’t come as much of a surprise to Labour MPs as Politics Home’s brilliant Paul Waugh revealed weeks ago. But MPs are always the last to hear these things anyway.

It means we will have had one of the longest parliamentary sessions on record even though we’ve hardly been scrutinising any legislation at all in the Commons in recent months. Instead we’ve been spending our time on innumerable backbench business debates with countless one line whips. All important stuff of course but rather odd when you consider we are elected to be legislators and we’ve not been doing much actual legislating.

Take the controversial Health and Social Care Bill. So despite it being one of the biggest issues in my postbag (actually inbox, nearly everything I get is by email but us MPs like to say “postbag”) and I suspect colleagues’ postbags (inbox) too, MPs have only had the opportunity to debate this monstrous bill in recent weeks because Andy Burnham tabled an opposition motion on the NHS Risk Register and asked what’s known as an urgent question on Nick Clegg’s health amendments as well last week.

So effectively Andrew Lansley in recent weeks has only come to the Commons to defend his policies because Labour has forced him to. Last month at health questions, genuine Lib Dem rebel Andrew George had a question on the order paper asking the Secretary of State whether he would withdraw the Health and Social Care Bill. Did Mr Lansley step up to answer it? No his loyal deputy Simon Burns was sent into the breach instead. “Frit” was the inevitable heckle from the more boisterous Labour MPs.


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Cameron’s war on all fronts reaches Stalingrad

28/02/2012, 12:00:26 PM

by Kevin Meagher

This July marks the seventieth anniversary of the start of the battle of Stalingrad, one of the key turning points of the second world war when the reckless German advance east was halted by the implacable might of the Soviet Union. Thus began the inexorable pushback to that bunker in Berlin.

David Cameron, a student of history, should take heed. He faces his own mini-Stalingrad, brought about by a combination of his ambition, hubris and receding good fortune.

But his enemy is more amorphous than the red army back in 1942. He grapples with three inter-connected problems, not one. The first is the on-going fragility of his coalition. His “formal” coalition partners, the Lib Dems, continue to flatline in the polls and desperately need to stamp their mark with policy concessions, hence their solo attempts to write the chancellor’s budget in recent days and wring concessions on the health bill yesterday.

But the prime minister’s “informal” coalition partner – his own party’s right-wing – is equally querulous. What is the point of being in power if you don’t get your own way? A theme former defence secretary Liam Fox rattled his sabre about on Sunday. Why should the Lib Dems get half the policy concessions when they only amount to a sixth of the coalition numbers, he whined. Why indeed?

These shaky foundations belie the Prime Minister’s second problem: the sheer ambition of his programme. It now seems a long time since those heady days when The Economist breathlessly talked of Cameron being “a radical force” establishing Britain as “the West’s test-tube”. That was only in August 2010, but like the German 6th Army, he is finding the reality of delivering change far harder than the promise of making it.


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The “new” health bill is a PR fix. Scrap it and start again.

28/06/2011, 09:30:45 AM

by Liz Kendall

This week, some parts of the government’s health and social care bill will go back through the committee stage of scrutiny by MPs.

David Cameron and Nick Clegg say they have listened and acted on people’s concerns. Now we’ve seen the government’s actual amendments to the bill, how does their claim match the reality?

The first problem with the government’s new NHS plans is that they are an even bigger mess than they were before.

Initially, the government wanted to scrap primary care trusts and strategic health authorities, set up the NHS commissioning board, public health England and the new monitor at the national level, and GP commissioning consortia and health and wellbeing boards at the local level.

Since then, new clusters of PCTs have been formed to “manage the transition” and David Nicholson, the chief executive of the NHS, has made it clear that he wants to have regional outposts of the NHS board (SHAs anyone?). Following its listening exercise, the government says that GP consortia will become clinical commissioning groups. It also wants to establish new clinical senates and have a bigger role for clinical networks.

These organisations come on top of the bodies that already exist, including the national quality board, the national institute for health and clinical excellence and the care quality commission.

Confused? You should be. It is now completely unclear who is responsible for taking decisions and leading changes in the NHS.


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The government’s NHS changes tell you everything you need to know about the Tories

06/06/2011, 08:29:05 AM

by Michael Dugher

When Parliament returns this week after the half-term recess, the spotlight will once again return to the battle over the government’s changes to the NHS. The so-called “listening period” is at an end and we will see if Andrew Lansley has really listened, or if the pause to the health and social care bill was merely a cynical, cosmetic exercise designed to shore up Nick Clegg’s position and maintain the coalition as a going concern. John Healey, Labour’s shadow health secretary, has done a brilliant job exposing the true nature of the government’s proposals for the NHS. He will table nearly 40 amendments once the bill comes back to the Commons to test the government’s willingness to listen and think again. But the government’s approach to the NHS tells us everything we need to know about the Tories and Labour’s attack might similarly apply to other areas of government policy too.

First, the changes to the NHS demonstrate that the Tories are reckless. Like in other areas – the so-called strategic defence and security review leaps to mind – the changes were rushed, careless and ill-thought through. The new bill is the largest legislative document in the history of the NHS. With its 136 clauses, the original text of the bill was so large that the chief executive of the NHS, David Nicholson, joked that it was “the only reorganisation you can see from space”.  The coalition agreement stated that it was the government’s intention to “cut the bureaucracy at the heart of the NHS”.  Yet the British medical association (BMA) claimed that the changes will “replace one bureaucracy with a perhaps even more dangerous one”. As John Healey has highlighted, the usual process for sound public policy, namely that of consultation-legislation-implementation, has been reversed.

David Cameron has tried desperately to “detoxify” the Conservative brand. He knew that central to the old image of the Tories as the “nasty party” was consistently polling so badly in the “who do you most trust to protect the NHS” question. Cameron has also read Tony Blair’s book. Blair once famously said: “Every time I’ve ever introduced a reform, I wish in retrospect I had gone further”.  But when it comes to the proposed changes to the NHS, the Conservatives are guilty of seriously over-reaching themselves. They simply do not understand that the national health service is a cherished institution for the British people.  We all want to see improvements – big ones – but all governments must proceed with care.


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Where’s the social care in the health and social care bill?

23/03/2011, 03:00:23 PM

by Peter Watt

There has been, rightly, an awful lot of attention given to the government’s health and social care bill. It proposes opening up the delivery of NHS services to any willing provider and the introduction, in some instances, of competition on the basis of price rather than outcome. Controversial stuff. Especially as the Conservatives promised no “top down reorganisation” during the election.

But there is one aspect of the bill that hasn’t been much commented on. It is misleadingly named. It is a “health” bill, certainly, but it is not a “social care” bill at all. This is not a pedantic point. The bill does not cover the social care system, which provides care and support to hundreds of thousands of people across the country in their homes and in residential settings. Last year, social care cost the state in the region of £27 billion. And individual families billions more on top. Many people do not realise that social care, unlike health, is not universally free.

Basically, if you have assets of more than £23,500 then you have to pay. If you become old and infirm, and need help staying at home, you will probably pay. If you need to move into a residential home, you will probably pay. With the average cost of a room in a nursing home at £36,000 pa, it won’t come cheap. (more…)

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No mandate for the biggest NHS reorganisation for 63 years

23/01/2011, 09:00:17 AM

by Amanda Ramsay

U-turn Dave, along with his Tory and new Lib Dem colleagues, made many an empty promise during last year’s general election campaign: VAT would not rise, frontline services would not be cut, the educational maintenance allowance would be safe.

And the Fib Dems promised the abolition of tuition fees, subsequently voting to triple them. The latest non-mandated policy is the health and social care bill, introduced to the Commons this week, heralding the largest reorganisation of the NHS since 1948.

This is despite the coalition agreement committing to quite the opposite, clearly stating: “We will stop the top-down reorganisations of the NHS that have got in the way of patient care”. In addition, the government’s health reforms feature in neither Conservative nor Liberal Democrat election manifestos, prompting Andrew Neil to ask on the BBC’s Daily Politics: “Are manifestos worth the paper they’re written on”? It is an alarming precedent. (more…)

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