With the release of two persuasive policy papers and an announcement from Ed Miliband that patients will be able to see their GP within 48 hours – Labour is currently seeking to set the agenda on health. Whereas many of the proposals made so far can sit comfortably alongside the current health system, some factions of the party are calling for the repeal of the Health and Social Care Act, which would certainly upset the status quo.
Shadow Health Secretary Andy Burnham and influential colleagues and health workers have claimed the NHS has become increasingly privatised and fragmented under the coalition government. In response to this, Labour has become more vocal about the possibility of, and likely repercussions resulting from, rolling back Section 75 of the Act which sets requirements as to procurement, patient choice and, crucially, competition.
The Parliamentary Labour Party Health Committee chaired by Debbie Abrahams MP recently published ‘An inquiry into the effectiveness of international systems’ which concludes health equity and quality is compromised by competition. It recommends the party exempt the NHS from the EU/US Transatlantic Trade and Investment Partnership and looks to define the terms for private healthcare providers’ involvement in the NHS. The fiercest opponent of the Act, Andy Burnham, has called for a return to NHS Preferred Provider status which would see the independent sector only used where there are gaps in delivery or where the NHS is unable to provide care to a high standard.
Seemingly contributing more quietly to the debate is Lord Warner, Minister for Health Reform in Tony Blair’s government. In his report, which is also likely to inform the party’s internal policy review process, although to a lesser extent, Warner looks to facilitate the diversification of the health and social care market. Lord Warner claims we need to be “debunking the myths that, somehow, competition is incompatible with integration and that public provision is always superior to private.”
To what extent independent providers would be limited from delivering NHS care under Labour, if at all, is still unclear and unlikely to be fully realised until policy is formally adopted in September 2014. Although early indications based on an opinion audit of recent recommendations to the party and sentiment within it, would suggest that Labour will seek to limit independent provision, the leadership may decide to leave themselves more wiggle-room with the increasingly strapped-for-cash health service.
Over the coming months, Labour will have to consider whether the economic realities facing the NHS, and the current focus on quality and patient experience, are conducive to re-introducing preferred provider status. Might it be possible to curtail the Act’s prescription on competitive tendering but leave the option open to involve the independent sector in the future? Lastly, does Labour’s vision for the NHS threaten the emerging consensus across the new regime at NHS England, Monitor and CQC, and if so, can the system handle more upheaval?
Jessica March
Account Executive, Westminster Advisers
Stay tuned for further indications over the next few months on how this will unfold. Read more on the Westminster Advisers blog.