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Open Letter


3rd March 2022

Dear Parliamentarians,

Re Health and Care Bill

We stand opposed to the Health and Care Bill, which would represent a dangerous, undemocratic and extraordinary power-grab by ministers. As the 15th Report of the Delegated Powers and Regulatory Reform Committee of the House of Lords[1] explained:

    “The Health and Care Bill is a clear and disturbing illustration of how much disguised legislation a Bill can contain and offends against the democratic principles of parliamentary scrutiny.”

If the Bill were to pass unamended, it would give ministers the powers to steer the UK’s healthcare system in any direction they chose, without further scrutiny by parliament or by the courts.

Such a concentration of power, without corresponding duties and devoid of scrutiny, would be inappropriate for any government. But given the stated motivations of this government, the risk to the health of the UK population is unacceptable.

As Sir John Major[2] commented,

    “The concept that [the Cabinet] would care for the National Health Service is a rather odd one: Michael Gove wanted to privatise it; Boris wanted to charge people for using it; and Iain Duncan Smith wanted a social insurance system. The NHS is about as safe with them as a pet hamster would be with a hungry python.”

And the Health Secretary’s speech to the 2021 Conservative Party Conference[3] on who should pay for health and social care leaves little to the imagination:

    “We, as citizens, have to take some responsibility for our health too. We shouldn’t always go first to the state – what kind of society would that be? Health and Social Care: it begins at home. It should be family first, then the community then the state.”

We therefore call upon MPs and Lords from all parties – from the Left, through to one-nation Conservatives – to vote against the Bill at every opportunity and in favour of any amendments that will help to preserve the NHS, as it should be, for future generations and subject to effective parliamentary oversight.


Yours faithfully,

Stephen Fry, Actor
Dr Julia Patterson, Chief Executive, EveryDoctor
Lloyd Hardy, Founder, GOV2.UK
Dr Alastair Fischer, Co-Leader, National Health Action Party
Marcus Chown, author, journalist and National Executive Committee member of the National Health Action Party
Anthony Johnson, Registered Nurse and Lead Organiser, Nurses United
Mark Kieran, CEO, Open Britain
Liz Crosbie, Project Director and Co-Founder, Reboot GB
Dominic Minghella, Take Back Britain
Mark E Thomas, Founder, The 99% Organisation

The following members of Independent SAGE have co-signed in an individual capacity:

Professor Susan Michie, FAcSS, FMedSci, FBA, Director of UCL Centre for Behaviour Change, University College London
Professor Christina Pagel, Director of the Clinical Operational Research Unit, University College London
Stephen Reicher, Wardlaw Professor of Psychology, University of St. Andrews
Helen Salisbury, Senior Medical Education Fellow, Nuffield Department of Primary Care Health Sciences, University of Oxford
Kit Yates, Co-director of the Centre for Mathematical Biology, University of Bath

If you want to write to your MP about the Bill, you can easily do so here.

Critical Amendments

Here is a list of the most critical amendments[4] needed, in addition to voting against the Bill at every opportunity, if we are to have a chance of preserving and rebuilding a properly-functioning NHS, offering a comprehensive and accessible health service to UK citizens, free at the point of use and funded through progressive taxation.

What the Bill does What it should do: Amendments Needed

The Bill removes the obligation for public tendering for NHS services and allows ministers to circumvent normal procurement rules. The Government should protect the NHS from unnecessary and costly private sector involvement and ensure scrutiny and transparency over the awarding of contracts. The most effective way of doing that is to make the NHS the default option for NHS contracts and to tender competitively where this is not possible.
The legislation leaves open the possibility for corporate healthcare providers to gain seats on ICS boards which represents a clear conflict of interest and gives them undue influence in decision-making. Keep governance under the control of those whose fiduciary duty is to patients and to the NHS rather than to shareholders
There will no longer be an enforceable statutory duty on any body to arrange provision of secondary (i.e., hospital) medical services – only a power for ICBs to do so.
Gives new and considerable powers to amend or abolish existing arm’s length bodies, create new NHS trusts and to intervene in reconfigurations of the health service.
Reintroduce a duty on the Health Secretary to provide a high-quality health and care service, free at the point of use for all UK citizens.
Introduce an enforceable statutory duty on the ICBs to ensure provision of secondary medical services. Ensure adequate funding to meet the needs of the population.
Gives ministers greater control over patient data. Impose strict protection on patient data unless totally anonymised (not merely de-personalised) especially when given or sold to commercial organisations.

References

Delegated Powers and Regulatory Reform Committee. (2021, 12 16). 15th Report of Session 2021–22. Retrieved from https://committees.parliament.uk/: https://committees.parliament.uk/publications/8311/documents/84578/default/

Javid, S. (2021, 10 5). Speech to the 2021 Conservative Party Conference. Retrieved from Twitter: https://twitter.com/sturdyAlex/status/1445424450854391810/

Mason, R. (2016, 6 5). John Major: NHS at risk from Brexit ‘pythons’ Johnson and Gove. Retrieved from https://www.theguardian.com/: https://www.theguardian.com/politics/2016/jun/05/john-major-nhs-risk-brexit-pythons-johnson-and-gove/

The 99% Organisation. (2022, January 15). Submission to the Lords on the Health and Social Care Bill. Retrieved from https://99-percent.org/: https://99-percent.org/wp-content/uploads/2022/01/Submission-to-the-Lords-on-the-Health-and-Social-Care-Bill-v3.pdf

Thomas, M. E. (2021, 9 28). Amending the Health and Care Bill. Retrieved from https://99-percent.org/: https://99-percent.org/amending-the-health-and-care-bill/

[1] (Delegated Powers and Regulatory Reform Committee, 2021)

[2] (Mason, 2016)

[3] (Javid, 2021)

[4] (The 99% Organisation, 2022)