Deputy PM demands removal of proposals designed to encourage competition and private sector involvement
The dispute within the coalition government over NHS reforms has intensified after Nick Clegg demanded the removal of another main plank of the proposals designed to encourage competition and private sector involvement.
The deputy prime minister has put himself on a collision course with the health secretary, Andrew Lansley, by proposing that a clause of the bill encouraging “any qualified provider” to take over services from the NHS should be radically rethought or dropped.
Clegg told senior figures in his party he would scupper Lansley’s bill unless the Tories agreed to the new demand. He has already insisted on the scrapping of the duty on the NHS regulator, Monitor, to compel hospitals to compete with each other. He wants it to be replaced with a duty to promote collaboration.
Speaking on Thursday at a meeting of the leadership of his party, including the chief secretary to the treasury, Danny Alexander, policy chief Norman Lamb, and health and social care minister Paul Burstow, Clegg said: “Everybody accepts the need for reform, but nothing is more important to me than getting these reforms right. This should not be about imposing different providers from the top, but should be driven by what is needed by patients at the bottom.”
The Lib Dems’ move will cause potentially unsustainable tensions in the government, where there is growing restlessness on the right of the Tory party about the posturing of their coalition partners over the health and social care bill.
Lansley’s legislation is designed to encourage the further involvement of the voluntary and private sectors by giving GPs the power to choose private healthcare for their patients over NHS hospitals. But amid growing concerns over the potential privatisation of the healthcare system, Liberal Democrats now want to offer protection from competition for NHS hospitals already struggling to make £20bn of savings, which the NHS chief executive, Sir David Nicholson, has demanded by 2015.
A party statement said: “We must drop the plans to introduce overnight a blanket policy of ‘any qualified provider’, as this risks destabilising too many providers [hospitals] at a time when they are having to make huge savings. Instead we should open up new services in a steady, phased manner, driven by patient demands.”
At the meeting the leadership of the party also rejected Lansley’s bid to remove the health secretary’s power to prevent the closure of hospitals.
Clegg agreed to insist to the prime minister and Lansley that all healthcare providers, including private firms, should contribute to the training of doctors and nurses.
The dramatic development came as a survey of the country’s leading private healthcare companies showed that four out of five of their bosses believed the current NHS reforms would provide an opportunity for them to profit.
Strategic consultants the Parthenon Group, who interviewed the chief executives, found firms either believed they would benefit by taking over services now monopolised by NHS hospitals, or that government policy would starve the NHS of funds and drive more people to take private insurance or “self-pay” – eschewing free care to go private.
According to the survey, the overwhelming majority of the firms questioned said they were planning to spend more money on a marketing drive aimed at both GPs, who will have the power of commissioning under the reforms, and at patients in order to boost the profile of their “brands”.
More than 60% expected to increase their spend on marketing focused on patients.
Alistair Stranack, head of global healthcare practice at Parthenon, said: “They were saying in short term it is difficult for the private sector as it is for the NHS but, longer term, if we make the assumption, which most of them were doing, that the government would at least move forward partially or mostly with the reforms then there would be opportunities for the private sector to play a greater role in the provision of services.”
The survey was seized on by critics. Shadow health secretary John Healey said: “This exposes the truth at the heart of the Tories’ NHS plans. The big winners will be private health firms, not patients. These companies are not waiting about – they are already hard-selling their services into the NHS.”
Last week the prime minister was accused of attempting to privatise the NHS after the Observer revealed that Mark Britnell, invited to Downing Street to provide advice earlier this month, had told a conference in New York the NHS would be shown “no mercy” and would become a “state insurance provider rather than a state deliverer” of care.
Cameron subsequently distanced himself from Britnell, an executive at accountancy giant KPMG, claiming not to have heard of him, although it later transpired the health expert had been the chief executive of the strategic health authority serving the prime minister’s constituency at a time when he was campaigning to have a new hospital built.
The row over Britnell was further inflamed by the deputy prime minister Nick Clegg earlier in the week who said: “People get confused when one day they hear politicians declare how much they love the NHS and the next they hear people… saying that reform is a huge opportunity for big profits.” NHS Liberal-Conservative coalition Andrew Lansley Nick Clegg Health Denis Campbell Daniel Boffey guardian.co.uk © Guardian News & Media Limited 2011 | Use of this content is subject to our Terms & Conditions | More Feeds
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