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NHS legal opinion: respond to your MP

September 2nd, 2011 by

Stethoscope

Photograph by diekatrin (Flickr)

Lots of MPs have been responding to 38 Degrees members with their views on the government’s plans for the NHS. Members have been sharing their responses here on the 38 Degrees website.

Now we’ve had a couple of days to look through those answers together, it’s clear that some myths about the NHS plans and our legal opinions are coming up again and again. Below, there are the key points which keep cropping up, as well as one or two suggested responses.

How else could we respond to these points? Are there any other arguments which just keep on coming up, which we could work together on responding to? Please share your ideas in the comments section below, to help draw up a mythbusting factsheet for MPs before the vote next week. This blog is a “work in progress”, so please share ideas for improvements, as well as telling us if you spot a mistake.

If you want to pick up on the some of the specific points with your MP, you can send them an email by clicking here.

Myth 1: Confusing “duty to promote” with “duty to provide”
Some MPs have said: ‘Their own legal advice confirms that there will be no change to the core duty on the Secretary of State to promote a comprehensive health service.’ (David Gauke MP, Jim Dowd MP, Laurence Robertson MP)

Response: Our legal opinion wasn’t about “duty to promote”. It was about “duty to provide”. That’s a pretty important difference. When MPs talk about duty to promote, they’re not answering our questions about the bill.

In the legal opinion about duty to provide it said:
“3. Effectively, the duty to provide a national health service would be lost if the Bill becomes law. It would be replaced by a duty on an unknown number of commissioning consortia with only a duty to make or arrange provision for that section of the population for which it is responsible. Although some people will see this as a good thing, it is effectively fragmenting a service that currently has the advantage of national oversight and control, and which is politically accountable via the ballot box to the electorate.”

“4. As set out in case law relating to the 2006 Act and its predecessor, the NHS Act 1977,when the Secretary of State or his delegates carries out the section 3(1) duty to provide services, the duty to promote a comprehensive health service in England, under section1(1), has to be borne in mind at all times. There will be severance between the two duties, if the Bill becomes law, as the bodies that will have the duty to arrange services pursuant to section 3(1) (the commissioning consortia) do not have a duty to promote a comprehensive health service.”

Questions for MPs who have made this point:
- How do you understand the relationship between duty to provide and duty to promote?
- If the Health and Social Care Bill is not amended to include the Secretary of State’s duty to provide a national health service, will you oppose the bill?

Myth 2: The duty to provide doesn’t exist
Some MPs have said: ‘38 Degrees suggests that the Health and Social Care Bill, “removes the Secretary of State’s duty to provide”. However, 38 Degrees’s own legal advice states that the Secretary of State has never had such a duty to provide. Therefore, the Health and Social Care Bill makes no changes to the Secretary of State’s duty to provide, because it never existed in the first place.’ (Oliver Colvile MP, Caroline Noakes MP, Liam Fox MP)

Response: Our legal opinion discusses the situation now, under the NHS Act 2006, and what could happen if the bill becomes law. The legal opinion is clear that the duty to provide, contained in section 3(1) of the 2006 Act ultimately rests with the Secretary of State. The legal opinion says:

“[NHS Act 2006] Section 3(1) is the main duty for the provision of health services. The duty is again described in general terms (rather than in terms of providing services to individuals who have particular needs), but it is, at this point in the statutory framework at least, very much a function which rests with the Secretary of State.”

There’s then a long list of the Secretary of State’s duties – you can see it here.

The executive summary says that the duty to provide is currently on the Secretary of State and will be lost following the amendments.

“It is clear that the drafters of the Health and Social Care Bill intend that the functions of the Secretary of State in relation to the NHS in England are to be greatly curtailed. The most striking example of this is the loss of the duty to provide services, which is currently placed on the Secretary of State.”

The opinon explains that although the duty can be delegated by the Secretary of State, that doesn’t change the fact that the duty ultimately rests with the Secretary of State. If the changes go ahead, that will no longer be the case.

Questions for MPs who have made this point:
- Some MPs are saying the duty to secure provision of NHS services will be catered for in the new legislation, but you’re saying it doesn’t exist.
- Who’s right? Can you explain the confusion?

Myth 3: This bill doesn’t make any changes to competition law, so nothing will change about the way competition law affects the running of the NHS
Michael Fallon MP said “In fact, the Bill does not change competition law as it applies to the NHS”, while David Gauke MP says, ‘No extension of European or domestic competition law as a result of the Health and Social Care Bill.” (Michael Fallon MP)

Response: Our legal opinion makes clear that, as things currently stand, the application of competition law to the NHS has not yet been fully tested in the courts, so it hasn’t yet been applied to the NHS. In fact, because of other changes to the NHS that have happened recently, it’s likely that competition law could be found to apply. However, our independent legal opinion also makes clear that the changes in the bill,

“will serve to reinforce that conclusion and introduce elements which make it even more likely that domestic and European competition law applies to the NHS.”

The full-scale application of competition law to the NHS has not been discussed by the Government. It’s not enough to simply state the Bill does not change competition law. If competition law is found applicable by the Court, our independent legal advice says there is nothing that can be done to limit the way in which it is applied to the NHS.

Other questions for MPs who have made this point:
- If the Bill makes no changes to competition law, does it currently apply or doesn’t it?
- If it does, what is the potential impact of competition law on the NHS? Has this been considered by the Government?
- Do you think that the new health bill will increase court cases involving the NHS? If not, why not?

Myth 4: The Secretary of State’s duty to secure provision of NHS services will be catered for in the new legislation.

Some MPs have said: ‘You wanted reassurance that the Secretary of State’s duty to secure provision of NHS services will not be abolished or passed to another body. I can confirm that the Bill, as amended, will not abolish this duty or pass it to another body.’ (Jonathan Lord MP, Greg Barker MP, Simon Burns MP)

Response:

This is misleading. Our independent legal advice found that that the bill removes the “duty to provide” services from the Secretary of State and places it instead on the unaccountable clinical commissioning groups (and then only as a duty to “arrange provision”).

This shift has a further consequence which is to create severance between the duty to promote a comprehensive health service and the duty to provide services since, under the Bill, the former will be held by the Secretary of State and the latter by the groups.

In addition, the Bill introduces a “hands off” clause that prevents the Secretary of State from stepping in unless it is essential.

Each of the above issues was explained in detail in the legal advice obtained by 38 Degrees. This is how 38 Degrees believes the Secretary of State washes his hands of the NHS and is not a concern that has been addressed.

Questions for MPs who have made this point: -

How will a comprehensive health service be guaranteed when the duty to provide the health service and decide on its scope is owed by consortia and not the Secretary of State and where the Secretary of State is required to grant the consortia maximum autonomy?

Myth 5 Lots of other groups think the bill is now OK.

Some MPs have said: ‘You will be aware that the significant amendments the Government is making to the Health and Social Care Bill have been welcomed by many organisations, including the NHS Confederation, patient groups, and think tanks.’ (Simon Burns MP, Robert Buckland MP, Justin Tomlinson MP)

Response: Some organisations do support the proposals, but lots of organisations are still really worried. Those that are still worried include organisations with a great deal of expertise in health, who would be on the frontline of the new system, like the Royal College of GPs, the BMA, as well as patients’ groups, like the MS Society.

Questions for MPs who have made this point:
- Are you concerned that the body that represents the people who’ll be delivering much of this – GPs – still doesn’t back the bill?
- What about the patients’ groups that are worried?
- Doesn’t their opinion matter?

If you want to pick up on the some of the specific points with your MP, you can send them an email by clicking here.

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  • Jj52

    I believe this is the way to go and we should look at challenging the secretary of state in court on his legal obligations in particular when areas such as public ownership is involved and his right to alter conditions without a mandate from the people. That in effect would mean a referendum on every issue and not an election.

  • Rob

    Remember – with the retirements of Chris Mullins and Bob Marshall-Andrews – they are now all lying bastards feathering their own nests at our expense (have you SEEN the coverage of Alan Duncan and Libyan Oil by the way…?)

  • Kissy

    I am still very concerned that the principles of the NHS are being undermined and not at all convinced by the argument that private competitors wil improve the service.waiting lists are already being extended and the wonderful service we have recieved is already being undermined.I need assurance that our concerns will be considerd and this awful reprganiosation abandoned .Reform does not have to come by expensive reorganisation and a mere rearrging of the “deckchairs on the titanic”

  • ernie

    not had any response from my MP STEPHEN METCALFE

  • http://pulse.yahoo.com/_2X3IXQ36P2VOCYCQ57MKEXVHVQ JENNY

    I haven’t had a reply yet from my MP, David Rutley. When I’m clearer on where he stands I will gladly share it on 38 degrees website and raise follow up questions but time is running out. Could be a tactical move on his part and others like him who have yet to provide replies to their constituents.    

  • Hupele

    I haven’t had a reply from my MP Esther McVey. They ignore us at their peril. We will get our way. We pay their wages,and put them in power. I hope they don’t think they can do anything without our backing!!

  • Sandra

    No reply from Lyn Brown

  • Andragon

    I have received an email from my MP Connor Burns’s assistant saying that CB will reply by letter at a later date.  No letter has, so far, been received.  Kicking it into the long grass?
    Andrew

  • Brian B

    I have sent 2 emails to my MP Daniel Poulter re the NHS changes but never got so much as an acknowledgement. Even though he was (or still is) a hospital doctor!

  • Lynne

    I have not had a reply from my MP Dr Sarah Wollaston. She replied last time, fairly positively, but rather late. I think 38 Degrees should contact her directly as she is on the Health Committee and turned down a govt. job so she could speak her mind. She does not want to see the NHS damaged or privatised 

  • Hannah L

    Keep trying, or perhaps give his office a ring?

  • Hannah L

    Hi Andrew – it might be worth giving his office a call?

  • Patricia Walker

    Please be aware that there is an unfortunate confusion of phrases in 38 Degrees’ ’NHS Legal Opinion – Respond to your MP’ bog of 2 September 2011.  Under Myth 2, Questions for MPs who made this point, ”duty to secure provision” should be replaced with ”duty to provide”.
    It is confusing to state, in Myth 4′s Response to your MP, that “many of our questions to MPs were about “duty to provide”. But this answer talks about the “duty to secure provision” – and that’s something different. It’s important not to confuse the two different things. If an MP answers a question about “duty to provide” with an answer that talks about “duty to secure provision”, they’re not answering our question”.

  • Juleshm

    No reply as yet from David Burrowes. I will follow this up on Monday.

  • Anonymous

    No response from Guy Opperman MP as of 1800 Sat 3rd Sep. He is back working, according to his newsletter, after recovery from a serious condition (treated by NHS!).

  • Saldridge8

    Reply from my MP ‘Peter Luff  was what I expected and was why I will not vote for him. “A load of nothing” He is the MP and he will decide.And yes he knows what 38 Degrees report is he has read it !!!!!

  • Leslie G. Shugrue

    All British Subjects should be cared for, not for wvery one that walks in the Country.
    Then it would not cost so much ?

  • Wrekin voter

    Sadly I’ve just had two out if office messages from my MP, Mark Pritchard, chair of the 1922 committee, informing me that he’s in recess and anyway will attempt to reply within 10 working days. I can’t recall when I last had a weekend or holiday when I didn’t work at home so well done Mark! Seems typical. Perhaps 38 degrees could focus on how we recall our MPs?

  • Marilyn Fetcher

    I’ve had a positive reply from my MP, David Crausby (Lab, Bolton North East): “I will do everything in my power to oppose this Bill at every opportunity”.  Have e-mailed full text of letter to 38 Degrees via contact page.  More like this!

  • Charles Anderson

    I have not received any reply from my MP Douglas Carswell is his e-mail address still in use as he always replied previously 

  • Michael Cutler

    Is this an appropriate place to post a reply to the ‘pro-forma’ response that I received from my MP. I used the link to the legal advice as I found that to be extremely clear and useful in clarifying my points of confusion. I also found the ‘questions you may like to ask’ from 38 degrees very useful:
    Dear Robert Goodwill,

     

    Thank you for your letter regarding my concerns about the
    Health and Social Care Bill.

     

    I am disappointed to find that you have sent me a pro-forma
    ‘press release’ in the guise of a ‘personal’ response that many of your
    colleagues have also sent to their constituents. The reply does not address my
    concerns and I would like to briefly state why.

     

    Firstly, you take issue with whether or not there has ever
    been a ‘duty to provide’ and confirm that there will be no such duty in the
    Bill. You use this apparent confusion to attempt to say that my concerns are
    without foundation. In fact under the NHS Act (2006)Section 3 there is a duty
    to provide and that duty is currently placed on the Secretary of State,
    although it may be delegated. Under the proposed Bill there would be a
    fragmentation of this responsibility to an unknown number of consortia. This in
    turn is likely to lead to a ‘postcode lottery’ pattern of provision that the
    Secretary of State, due the ‘hands off’ clause, will be able to do very little
    (if anything) about. I believe this to be profoundly undemocratic as it removes
    the accountability, via the ballot box, of the government for the provision of
    the nation’s health services.

    Can you explain to me how you can guarantee a comprehensive
    health hervice when the duty to provide it and decide on it’s scope is decided
    by individual consortia and not the Secretary of State AND where the Secretary
    of State is required to grant the consortia maximum autonomy.

     

    Secondly you take issue with whether the Bill would change
    the situation regarding competition law by stating ‘The … Bill therefore does
    not change the current situation’. If that is the case are you able to confirm
    to me whether competition law currently applies or not. If it does apply (and
    will therefore continue to apply should the Bill become law) can you tell me
    what the Government has considered to be the potential impact of this (for
    example expensive legal challenges from private providers).

     

    I am extremely concerned by these proposals and would like
    to know your personal opinions regarding the specific questions outlined above.

     

    Yours sincerely,

     

  • Alison Lawrence

    My MP, Harriet Baldwin doesn’t reply to an email with an email as she is ‘unable to authenticate her reply’ so I am unlikely to get a response before the vote, also she’s not at all keen to engage in debate with constituents who don’t agree with her.   

  • Alfred the OK

    Myth 5: This applies to the whole of the NHS….
    It doesn’t, just the EHS – the English Health Service, but nobody ever mentions it. The NHS is a fully devolved organisation – free prescriptions in Scotland, Wales & N.I. but not in England, etc, etc. How strange is it that massive changes to an organisation are intended yet no one ever seems to utter the place in which it is happening (just like education, planning & local gov’ matters). You call for honesty & openess yet continue with the Establishment conspiracy of never mentioning the ‘E’ word…..

    You can find the Scottish NHS here, http://www.scot.nhs.uk/ the Welsh NHS here, http://www.wales.nhs.uk/ the N.I. NHS here, http://www.n-i.nhs.uk/ …. You won’t find the English NHS anywhere because no one, including yourselves are willing to admit its existence.

  • Alice Ross

    Here’s my reply

    Dear Ms Ross

    Thank you for contacting me about the NHS reforms and the 38 Degrees campaign.

    The Government’s reform plans were examined in detail by the independent
    NHS Future Forum, which comprised the country’s leading doctors, nurses
    and NHS experts. They concluded that the twin demands on the NHS – of
    an ageing population and of rising costs of new treatments and
    technologies – meant that reform of the NHS was needed. They also
    recommended significant changes to the Government’s original plans,
    which we have accepted. These significant changes have addressed many of
    the concerns originally raised by 38 Degrees and others.

    The Government has already responded in detail to 38 degrees. In that
    response it was made clear the Secretary of State will continue to be
    responsible – as now – for promoting a comprehensive health service. The
    NHS will always be available to all, free at the point of use and based
    on need and not the ability to pay. To say otherwise is completely
    incorrect.

    I can assure you that 38 Degrees’s concerns are without foundation, as
    their own legal advice has confirmed. Firstly, 38 Degrees suggests that
    the Health and Social Care Bill, “removes the Secretary of State’s duty
    to provide”. However, 38 Degrees’s own legal advice states that the
    Secretary of State has never had such a duty to provide. Therefore, the
    Health and Social Care Bill makes no changes to the Secretary of State’s
    duty to provide, because it never existed in the first place.

    Secondly, 38 Degrees suggests that the Health and Social Care Bill opens
    up the NHS to competition law. However, once again, 38 Degrees’s own
    legal advice states that competition law already applies to the NHS. The
    Bill does not change current UK or EU competition legislation or
    procurement legislation or the areas to which they apply. Competition is
    not, and will not be, used as an end in itself.

    We are all proud of our National Health Service, and I want to assure
    you that this is a very important issue to me, as it is to many of my
    constituents in Brighton Kemptown and Peacehaven. I believe that
    modernising the NHS will both safeguard the future of our local health
    services, and will deliver a world class National Health Service that
    puts patients at the heart of everything it does. I will be sure to
    monitor developments very closely and I will be reporting back to
    constituents on this issue in the coming weeks.

    Thank you again for taking the time to contact me. I hope that this
    email is helpful in addressing the concerns that you have raised.

    Kind regards.

    Yours sincerely,

    Simon Kirby MP
     

  • Warren knight

    Ten or twenty hospitals are to be run by German company Helios in secrete talks with
    ministers, back door privatisation?

  • Stefanie

    much the same reply from Hugh Robertson:

    Thank you for contacting me about the NHS reforms and the 38 Degrees campaign.

    I am deeply committed to the NHS, as is the Prime Minister who said,
    ‘you could sum up my priorities in just three letters: N-H-S’.

    Our reform plans were examined in detail by the independent NHS Future
    Forum, which comprised the country’s leading doctors, nurses and NHS
    experts. They concluded that the twin demands on the NHS – of an ageing
    population and of rising costs of new treatments and technologies –
    meant that reform of the NHS was needed. They also recommended
    significant changes to the Government’s original plans, which we have
    accepted. These significant changes have addressed many of the concerns
    originally raised by 38 Degrees and others.

    I am unsure as to the basis of the latest concerns expressed by 38
    Degrees. First, 38 Degrees suggests that the Health and Social Care
    Bill, “removes the Secretary of State’s duty to provide”. However, 38
    Degrees’ own legal advice states that the Secretary of State has never
    had such a duty to provide – only a duty to promote – a comprehensive
    health service. This duty remains unchanged by the Health and Social
    Care Bill, as it has since 1946.  I would like to assure you that the
    Secretary of State will retain overall accountability for the NHS.

    Second, 38 Degrees suggests that the Health and Social Care Bill opens
    up the NHS to competition law. However, once again, 38 Degrees’ own
    legal advice states that competition law applies to the NHS, and the
    Health and Social Care Bill does nothing to change how domestic or
    European competition law is applied.

    I hope you agree with me that 38 Degrees’s concerns are without
    foundation, as their own legal advice has confirmed. Thank you again for
    taking the time to contact me.

  • http://www.facebook.com/profile.php?id=649995276 Paul Tyler

    Got exactly the same reply from Rebecca Harris MP for Castle Point.  Thankfully, I re-replied to her using my own words, so at least there is one thinker in the constituency!

  • Woodczuk

    My MP, Ian Liddell-Grainger, has sent me a typed letter that is almost word for word identical to Hugh Robinson’s – it seems he is deeply committed to the NHS but not deeply enough to read the detail and write a genuine response

  • Juleshm

    David Burrowes has sent an identical reply;
    Thank you for your email regarding the NHS reforms and the 38 Degrees campaign.
    I am deeply committed to the NHS, as is the Prime Minister who said, ‘you could sum up my priorities in just three letters: N-H-S’.
    Our reform plans were examined in detail by the independent NHS Future Forum, which comprised the country’s leading doctors, nurses and NHS experts. They concluded that the twin demands on the NHS – of an ageing population and of rising costs of new treatments and technologies – meant that reform of the NHS was needed. They also recommended significant changes to the Government’s original plans, which we have accepted. These significant changes have addressed many of the concerns originally raised by 38 Degrees and others.
    I am unsure as to the basis of the latest concerns expressed by 38 Degrees. First, 38 Degrees suggests that the Health and Social Care Bill, “removes the Secretary of State’s duty to provide”. However, 38 Degrees’ own legal advice states that the Secretary of State has never had such a duty to provide – only a duty to promote – a comprehensive health service. This duty remains unchanged by the Health and Social Care Bill, as it has since 1946.  I would like to assure you that the Secretary of State will retain overall accountability for the NHS.
    Second, 38 Degrees suggests that the Health and Social Care Bill opens up the NHS to competition law. However, once again, 38 Degrees’ own legal advice states that competition law applies to the NHS, and the Health and Social Care Bill does nothing to change how domestic or European competition law is applied.
    I hope you agree with me that 38 Degrees’ concerns are without foundation, as their own legal advice has confirmed. Thank you again for taking the time to contact me and please do not hesitate to do so in future should you require any further information or assistance.

  • http://twitter.com/RobHopcott Rob Hopcott

    Yesterday received from ‘my’ MP Ian Liddell-Grainger the standard response others in his constituency have received and I responded in detail with the points made above.

    Now it’s just 4am in the morning and unable to sleep with worry about the NHS reform bill, I have just sent this additional email to him:

    To:    Ian Liddell-Grainger MP

    Indemnification of constituents for future charges resulting from Health and Social Care Bill

    It is now just before 4 am on the morning of the day that sadly you have said in your letter to me of 2nd September 2011 that you will vote in support of the Health and Social Care Bill.

    Frankly, I am completely unable to sleep because of my worries about the charges that will be levied on myself, a pensioner, and other constituents as a result of your support for the Health and Social Care Bill.

    You see, I really can’t afford any more costs and I am getting to the stage in my life that my health is not going to be as good as it has been in the past and I fear I will need the NHS rather more than I have previously.

    It is clear to me that the NHS will not cost less as a result of the Health and Social Care Bill. Instead, probably, it will cost more because of the introduction of an increased profit element from commissioned services.

    How is this extra cost going to be paid for? Certainly not from the government otherwise why would you have introduced the Health and Social Care Bill in the first place.

    So you will be expecting me to pay for the extra costs of the Health Service probably as a result of individual treatment I receive.

    I’m sorry but I do not have the money to be able to pay for this treatment. I have a pension of only £360 per month and a few savings. Even my savings have been reduced recently because I have had to pay for expensive dental treatment as a result of fees progressively introduced in recent years for so-called NHS dental services.

    Please can I ask you therefore for an undertaking to indemnify me and other constituents for charges made to us for treatment as a result of your support for the Health and Social Care Bill.

    Alternatively, if you vote against the Health and Social Care Bill today and help defeat it, such indemnification will obviously be unnecessary.

    I look forward to seeing you speak against the Health and Social Care Bill today.

  • IPUKV6

    Spot on Scotland and Wales have not the English problem today .

    Why does not the national English newspapers make this important difference in comments ?

    What about Freemen of England then moving into the debate ?
     these are the laws of England being changed before our eyes  we the people had some rights from long ago ..

  • Tom H

    My response to David Burrowes MP today at 11.30am.

    Dear David,
    Thank you for your response.  I am still very worried about the planned changes to the NHS.

    In relation to ‘any willing provider’ it seems clear to me that this will be a competition, like in local government, for a contract of services.  The chances are that this can be carried out more cheaply by a private company but they will make money either off the backs of patients or by cutting terms and conditions of staff, as has happened in local government.

    Privatisation in local government has been a disaster, please don’t let this happen to the NHS.

    The second element to this, would mean that competition law would likely apply to the NHS contracts which would undoubtedly lead to expensive court battles, wasting money that your government say should be going to the ‘frontline’ of NHS services.

    In relation to the duty to provide, I have to be frank and say, I don’t know what legal advice you were reading. It is clearly stated in s.3(1) of the National Health Service Act 2006, “The Secretary of State must provide” a National Heath Service (Paraphrased).  It is the abolition of this duty that I am concerned about.  This is fundamental to the accountability of any government with regards to health provison in this country.  This duty must remain with central government.

    Given what I have said above, I would be grateful for your response to the following questions:

    -As a result of opening up the NHS to competition with other providers, do you think that the new health bill will increase court cases involving the NHS? If not, why not?-Given that the duty to provide the NHS will no longer rest with central government, are you prepared to vote against this bill?-Are you concerned that GPs and the BMA oppose this bill?
    I really hope you decide to vote against this bill in its current form, until all notions of privatisation are removed. 

    Thank you for your time, I look forward to hearing from you.

    Regards,
    —Tom

  • alexmasterley
  • Aimee

    Here’s the response I received from my MP, Labour’s Chris Evans, dated yesterday.

    Thank you for contacting me about the Health and Social Care Bill. I can assure you that I will be voting to scrap or significantly amend this reckless, bureaucratic and wasteful reorganisation of the NHS, when the Bill returns to the House of Commons tomorrow.

    I have received a very large number of e-mails and letters from constituents on this important issue and I know how concerned local people are about the Government’s proposals. The major flaws identified by the 38 Degrees legal opinions are serious concerns, and reflect arguments that Labour have been making in Parliament and in public since last autumn.

    The Bill removes a key protection of the 1946 Act that set up the NHS – that the Secretary of State for Health should be directly accountable for providing the health service. The Government’s plans will break up the NHS as a national public service and are fundamentally weakening the Health Secretary’s responsibilities.

    The Government have not acted upon the recommendations of the independent group of NHS experts, the Future Forum. The Bill still contains the essential elements of the Tories’ long-term plan to set the NHS up as a full-scale market based on the model of the privatised utilities. Under their plans a new economic regulator will enforce competition law on the NHS for the first time, and have the power to fine hospitals 10% of their turnover for working together.

    I and my Labour colleagues oppose the Bill and have tabled amendments to stop the changes. We will continue to fight to save the NHS from this Tory-led Government.

  • Quillfiller

    Identical response from my Conservative MP for Ludlow, Philip Dunne. I’m just about to reply to him.

  • ddl

    I e-mailed Nicola Blackwood on Aug. 30th, and so far just received the following:

    Nicola Blackwood MPMember of Parliament for Oxford West and AbingdonHouse of CommonsLondon SW1A 0AAThank you for your email.This is an automated response to confirm receipt of your email, and you will receive this email each time you contact my office.  While I have not yet had the chance to read your message, I wanted you to know it has been safely received and will be acted on.I receive a very high volume of correspondence and telephone calls each day, dealing with them in the order in which they are received.We aim to respond to all correspondence as quickly as possible and do appreciate your patience.Please note that there is a strict Parliamentary rule that MPs can only help their own constituents.  You can click here to check if I am your MP by entering your postcode.If you are one of my constituents, please ensure you have included your full name, address and contact details. If you have not, please resend your email with this information.If your concerns are urgent and require a faster response then please do call the above number to bring them to my attention.Once again thank you for taking the time to contact me.Kind regardsNicola Blackwood MP

  • kaz

    responding to Warren Knight, l also have concerns about german companies taking control over a certain amount of hospitals.having been in the NHS for 25years and dealt with out of hours GP’s bought in to cover weekends and unsociable hours l and a collegue had a close shave with a prescription written up by a german Doctor, this was after he had borrowed my pen !!! and asked me the dose of Diamorphine l would recommend. I hope that any non UK clinical personnel go through strict scrutiny to stop any problems arising from language/ procedure barriers.

  • Mike Renwick

    Here is the reply sent by my MP, Labour’s Russell Brown dated 02/09/2011.

    Mike

    I recognise that there are still massive concerns about the direction of
    this piece of legislation, despite the so-called “listening exercise”. I
    am fully aware that Labour parliamentary colleagues are extremely
    anxious about the issues that have been highlighted by legal experts and
    although Parliament has been in recess, I am quite clearly seeing, from
    the number of e-mails that are circulating, that there is a
    determination to have these concerns addressed.

    Let me assure you that I will be meeting with my colleagues in advance
    of the debate taking place, and if at the end of the day, we do not feel
    that the coalition government has moved significantly to address the
    matters that mean so much to us, then it is very likely that we shall
    vote against the Bill.

    Again my thanks for contacting me on this vitally important matter.

    Regards

    Russell

    I realise that he has to “hedge his bets” but I was hoping for a more robust approach.

  • Phillangridge

    Here is the reply by my conservative MP. 

    Thank you for your email raising concerns about the Health and Social Care Bill. The NHS is of critical importance to all of us and I am grateful to you for taking the trouble to contact me. As you requested, I have read the legal advice that was obtained by the 38 Degrees lobbying group. Broadly there are two issues raised: the removal of the Secretary of State’s ‘Duty to Provide’ and the applicability of competition law to the NHS.

    As the legal advice states, competition law already applies to the NHS. The changes to the bill which were made in the Summer have removed a duty to ‘promote’ competition, so as far as I can see the only remaining obligation is to act in accordance with competition law. This obligation already exists.

    Regarding the ‘Duty to Provide’, the advice suggests that the result will be far more use of the private sector, but it also acknowledges that non-statutory changes over the last few years have already had that effect. The ‘any willing provider’ principle allows a suitable healthcare provider whether public or private to offer services within the NHS. I know that some people find it objectionable that private sector providers might be employed by the NHS but my own view is that the quality of service is paramount – as long as there is no cost to the patient. Furthermore, I don’t think that the ‘Duty to Provide’ is really central to the responsibilities of the Secretary of State in the way that is suggested by the legal opinion. It is the strength of parliamentary, public and press opinion that constrains a Health Secretary’s freedom of manoeuvre far more effectively than a statutory provision of this kind. I am confident that this will continue to be the case regardless of the votes in Parliament in the coming days.

    I will however, try to follow the detail of the debate and will be open to persuasion. Once again I am grateful to you for taking the trouble to write about such an important matter.

    Best wishes,

    Graham Brady MP

  • http://twitter.com/RobHopcott Rob Hopcott

    Just sent to ‘my’ MP Ian Liddell-Grainger:

    Where were you in todays debate on the NHS?

    I’ve just been watching the debate about the NHS Bill in the Commons for the last 5 hours and was sorry not to see you putting the points I made to you recently.

    It is completely clear that our ‘jewel’ of an NHS which is widely admired throughout the world is to be replaced by a network of warring corporations loosely and ineffectively regulated by an expensive administrative body called Monitor along the lines of water, electricity etc. providing services to the order of GP type bodies who will have to find time to do all this service commissioning work in addition to seeing and caring for their patients (an unlikely scenario, probably they will delegate to other US corporate subsidiaries).

    It will be a battle of the biggest lawyers who will stop at nothing until they have secured as much of the NHS market as they can. Probably several large corporations (eg. subsidiaries of American care providers) will end up providing everything. Small providers of medical services will not survive, if only because they can’t afford the expensive lawyers.

    Since the private patient ‘cap’ is to be withdrawn, these large care service providers will quickly offer ‘premium’ services in addition to the bog standard NHS care services and the number of people buying these services will grow until the free NHS services are just a rump and used only by the poorest in our community who will have to put up with a very poor service of care.

    Very much like in America, really, which of course is exactly what Secretary of State Andrew Lansley seems to want.

    Please could you tell me, as my elected MP, what you are doing to prevent this appalling state of affairs?

  • Anonymous

    so much for Mr cameron and cleggs promises to safe guard our health service, but we should of expected nothing less from a conservative government profits for the fat cats its, what it is all about.
    and the eventual total privatisation of the health system in this country, just more of there austerity the poor will pay 

  • Steve Athey

    I am not an expert on the application of EU competition law to the current arrangements for commissioning NHS services by PCTs. In fact I don’t know if it actually applies, for example, where PCTs commission clinical services, say orthopaedics or just hip replacement services. On the other hand EU competition law certainly does apply where NHS bodies, eg hospitals, contract for goods such as equipment or medicines, where the contract value exceeds the specified threshold. So, while it is correct to say that EU competition law currently applies to the NHS, it may or may not be true in relation to the current commissioning of clinical services. If it will be true under the new Bill when it isn’t currently true for clinical services then it is disingenuous, to say the least, for MPs to claim glibly, as they do, that there is no change in relation to competition law.
    Does anyone know if the commissioning of clinical services from NHS hospitals, by PCTs, is currently subject to EU competition law. I suspect it isn’t but would be happy to be proven wrong.

  • Spooniejune

    Thank you for your e-mail about the Report Stage of the Health Bill. Many constituents have sent on e-mails from 38 Degrees. My former colleague Evan Harris has been very active in advising them on the questions to ask and how to lobby Lib Dem MPs- hence the unusually detailed nature of some of the 38 degrees submissions.  As the only backbench Lib Dem MP who has served on both Committee stages on the Bill, I am well aware of  the detail and have spent much of  the last year living with it. I therefore, I hope, am in a position to give you a pretty informed overview and attach two detailed responses to the legal opinions offered by 38 degrees. I have been an outspoken critic of this Bill since the White Paper was published over a year ago but have seen substantial changes in it after the listening exercise, a whole raft of additional amendments  just tabled for the Report stage and still more promised in the Lords.  Their changes then come back to the Commons. During this whole process which may not finish til after Christmas I can assure you that I shall vote for nothing I do not believe or that will not be in the interest of the NHS but I  invite you to get in contact with me directly (533555) or (0207 219 8318) if you have particular concerns as clearly there is more to communication than sending on to one another other people’s opinions. I look forward to that. I enclose two detailed responses to the opinions you enclosed. As a critic of the Bill since it was first announced I have continuing concerns but I should also add that the current NHS is not the NHS created by Aneurin Bevan but the one dramatically changed by Tony Blair with choice and competition, independent Trusts, payment by results and increased involvement by the private sector under Any Willing Provider -all this exists in our NHS now. There is a gulf between how I would organise the NHS and how it is organised now and perhaps not such a big gulf as people think between Lansleys’ NHS and Blair’s.  Do read the enclosed responses and get back in touch if you want more details. All the best,  John Pugh

  • http://twitter.com/kayodei Kay Odei

    Got the same response from Greg Hands MP for Chelsea & Fulham

  • Swandodger

    Executive summary of response from Graham Evans, conservative MP for Weaver Vale: “I hope you agree with me that 38 degree’s concerns are without foundation, as their own legal advice has confirmed”. Nothing new in the body of the letter; most of it is already word-for-word below.

  • http://thoughtfulcampaigner.wordpress.com/2011/09/21/the-law-and-campaigning-are-we-missing-an-opportunity/ Using the Law in Campaigning – are we missing an opportunity? « thoughtful campaigner

    [...] in recent week, we’ve seen 38 Degrees turn to legal opinionto get another view on the proposed Health Bill that was going through Parliament, and use it as a [...]