New EU Health Regulations – improving patients’ rights or more NHS privatisation in disguise?

It is appalling that the recent NHS privatisation regulations have now been passed, despite a broad-based and vigorous campaign against them.

The Regulations, made under Section 75 of the 2012 Health and Social Care Act, essentially require all NHS services to be put out to competition unless there is only one provider capable of delivering them.

As Clare Gerada, Chair of the Royal College of GPs, has pointed out, with these changes the legal framework for a publicly provided, publicly managed, publicly planned and democratically accountable health service has been removed.

At a UK level, the only solution to this situation now is for an incoming Labour Government to reverse comprehensively the 2012 Health and Social Care Act and associated secondary legislation. But we must also go further and seek to re-examine and eliminate the purchaser / provider split wherever we can and in whatever timescale is feasible.

Against this background it remains important in the meantime that we are vigilant about European Union legislation that can impact negatively on our public services, health included.

To give one current example, the Department of Health is currently consulting until 24 May on the draft NHS (Cross-Border Health Care) Regulations 2013.

Although health services are largely excluded from EU competence, there have been moves for many years to try and open up the single market approach to healthcare provision, and to let in more competition by private providers based in other member states.

EU citizens already can obtain European Health Insurance Cards to ensure they can get urgent medical treatment when in another member state. So far, so good.

And the new draft Cross-Border Health Care Regulations are aiming to bring into force a 2011 EU Directive that gives patients ostensibly reasonable sounding rights to access planned healthcare treatment in other European countries.

But in reality, the Regulations do little more for patients than clarify rights in existing EU legislation and case law. They certainly do not address the problems of widening health inequalities within the EU, and the fact that those from poorer countries will still not be enabled to access much needed specialist treatment elsewhere.

And buried in the impact assessment accompanying these official regulations (at p.23), there is a section explaining the real drivers. This section emphasises the potential for increasing competition amongst UK and EU healthcare providers and diversifying income streams for domestic private providers.

It is vital that Labour and other concerned campaigners lobby to get the regulations changed so that the Directive is brought into effect in the least damaging way possible. One option would be to argue that prior authorisation procedures should have the highest possible safeguards against funding private treatment overseas and it should not be authorised unless the NHS is incapable of providing the required treatment.

In the longer term, these regulations illustrate yet again that Labour and Socialist MEPs must work together to change the basis of the EU attitude on public services to one of solidarity and fair access for citizens and not as a market for companies to make profits.

Lucy Anderson is a Labour MEP candidate for London and a member of Labour’s National Policy Forum Health and Care Commission

London Labour and the anti-cuts movement

This weekend’s credit rating downgrading is yet another reason why the Labour Party must become more outspoken in its opposition to austerity. Growing opposition to the impact of Tory spending cuts on people’s living standards demands that the party connect with emerging community campaigns in defence of public services.

But alongside this, as it develops an investment alternative, it must begin by saying that Labour will reject spending cuts mapped out by George Osborne for a post-election government.

For me, this was the message from members at London Labour Party conference on 16th February, who were in a combative mood, with the Tory government in their sights. London Labour members want their representatives to employ a language that connects with ordinary voters and voices public outrage at the impact of Tory cuts. Policy debates saw repeated attacks on the cuts, whether in emergency services, health, education or local government, delivered by activists from all wings of the party with a greater urgency and a harsher tone than anything heard in Westminster.

Much of the talk was defensive and focused on the immediate threats to living standards brought about by the cuts now coming into force. The current hospital campaigns across the capital and the imminent implementation of benefit cuts were at the forefront.

But members were also encouraged by Ed Miliband’s opposition to the proposed benefit cap and redistributive proposal in the week before of a mansion tax to fund a reduced income tax band for those earning least. Popular with the public, it is also popular with members.

Facing those immediate threats though, there was a clear desire to co-ordinate our opposition, pool our resources, and focus fire on the Coalition. In policy terms the key arguments were that we must oppose privatisation while giving a robust defence of government and local authority intervention in the market. The leadership must take this cue to champion interventionism.

This was demonstrated in the NHS debate, with the commitment to ‘restore the principle of a publicly owned, publicly provided, and publicly accountable NHS’ and to ‘work with health unions, the medical and other health professionals and NHS supporters to campaign against privatisation, cuts and closures’ from the 2012 Annual Conference was passed.

And in the housing debate, where the key policy motion stated that ‘where housing benefits are high, the beneficiaries are not, in fact, the low waged tenants, but the extortionate landlords who own the homes and the skinflint employers who pay them such low wages’. Capping rents, regulating private rented sector, initiating an urgent expansion of council housing and using public funds to bring empty and unused properties back into use were all proposed as alternatives.

We clearly need better co-ordination in the London Labour family on housing. While a few campaigning administrations stand out, too many do not. There are good Labour councils working hard to challenge the government policies that are exacerbating the housing crisis but not everyone within Labour is doing the same thing. A very welcome vote in favour of a special Labour conference of Labour Groups and CLP members backed by the conference, is an opportunity to co-ordinate that.

And the explosion in public outrage at the impact of spending cuts in the NHS was clearly represented in the conference hall. The impressive campaign to save Lewisham Hospital has set the standard for a myriad of campaigns across London to defend other hospitals, including my local, the Whittington. The UNISON motion took apart the privatisation plans in the Health and Social Care Act, while four emergency motions were submitted and passed, committing the London Labour Party to back London demonstrations in defence of the NHS, until a Labour government can reverse cuts.

With an increased willingness to oppose individual cuts, we must develop the broader narrative of ‘austerity isn’t working’. Community campaigns against cuts must be supported, but we need to put our money where our mouth is. As the Labour Party must become more outspoken in its opposition to austerity it should make absolutely clear its outright rejection of any spending limits set out for a post-election government.

Even before it is prepared to set out it’s spending commmitments, the Labour leadership must make clear there is no future for the Coalitions disastrous cuts under a Labour government.

It can and should make that commitment now, but it must develop its own interventionist spending alternative. Because while we oppose cuts for their attack on living standards, we also know investment is necessary to generate new jobs and economic growth.

The anti-cuts campaign is stepping up, Labour must be part of it.


London Labour Party Conference February 2013 decisions

The Dorries Amendment: What happened? What next?

It’s been all over the news this week, but what exactly is happening to abortion services?

Nadine Dorries amendment on changing the abortion counselling was rejected last Wednesday by an amazing majority of 250. But what was it she was trying to do and why was it damaging?

The amendment if passed would have prevented providers of abortion, such as the British Pregnancy Advisory Service (BPAS) from offering counselling to those facing an unplanned pregnancy. Ms Dorries claimed that these organisations were not impartial and thus the counselling they were giving was not appropriate.

Nevertheless, as Diane Abbott clearly stated in her rebuttal speech the amendment was a ‘shoddy, ill-conceived attempt to promote non-facts to make a non-case – namely that tens of thousands of women every year are either not getting counseling that they request or are getting counseling that is so poor that only new legislation can remedy the situation’.

Despite Dorries best attempts to make us believe that they do, organisations such as BPAS have no vested interest in persuading people to have abortions, they are not for profit and exist purely to help women who face unplanned pregnancies. The current law already ensures that these organisations give impartial counseling to any women who requires or would like it. Any suggestion that this isn’t happening makes the assumption that these counselors are breaking the law and not doing there job correctly. Yet all the staff at BPAS undergo scrutiny by the Care Quality Commission and receive regular feedback from their clients. If the staff were not doing their job – we would know.

If this amendment had of passed then it would have paved the way for anti choice groups, such as LIFE, to offer this ‘independent’ counseling. Also it would have been a further step, a further delay and a further obstacle for women seeking an abortion. A recent observation of a BPAS clinic showed that the process is already too long. Clients commented “Make it quicker,” and “Less waiting, adds to anxiety.” The observation concluded that “no one felt rushed’.

Thankfully the amendment was defeated, however this may not be the end of it. Anne Milton, the Government Health Minister stated that ‘she agreed in principle’ to the aims of the amendment and agreed to look into counseling provision. If they decide to change it, it could result in women being sent to somewhere else, after getting the two doctors permission and meeting with an abortion provider. This is at best an inconvenience but at worst, for those in rural areas, or who have come from Northern Ireland where abortions are still largely illegal, or who cannot take another day of work or who cannot afford the travel costs or cannot find someone to look after their kids ect ect, having an abortion could become an impossibility.

Dorries claimed in her speech that many pro-choice campaigners refuse to discuss changing the abortion provision and that is why they are opposing this amendment, but there is much that we would like to discuss and change. If there was an amendment in favour of getting rid of the two doctor requirement, or allowing Northern Ireland to have abortions on the NHS, or changing the procedure of an Early Medical Abortion so that the second pill can be taken at home (as is done in the instances of miscarriage) then many of us would be supporting it. Pro-choice campaigners want to have these discussions but the debate needs to be turned on its head. In recent years pro-choice campaigners have continually been on the back foot as anti abortionists attempt to chip away at abortion rights.

For our abortion rights to be protected and extended we need to reclaim this debate.