Dr. Charles West is submitting an Emergency Motion on the NHS reforms. If you would like to support this motion please click here to sign up.

Reforming the NHS

Conference notes that the March 2011 Conference clearly rejected several aspects of the Health and Social Care Bill (“the Bill”), which breached the agreed Coalition Programme. Conference applauds Nick Clegg and our ministerial team on achieving changes to the Bill reflecting some of those concerns. Conference however further notes a) that since the beginning of July the Bill has been amended in the Public Bill Committee without fully addressing our concerns. b) that the Government published further amendments on 2nd September for the report stage of the Bill on the 6th and 7th September 2011 without address any of the outstanding concerns. c) the amended Bill still contains significant proposals for the NHS which go well beyond the Coalition Programme and have widely criticised by health professionals, academics, managers, and the wider public over the Summer. d) after the re-examination of the Bill in committee and after Parliament had gone into recess the Health Secretary issued instructions to PCTs obliging them to identify three services to be put out to contract in an exercise that could see an extra £1bn of NHS money being paid to private providers. Conference is concerned that: I. the underlying Conservative agenda is the fragmentation and privatisation of the NHS, with the Secretary of State and the NHS no longer delivering healthcare but simply buying it in the ‘market’. II. the promotion of “choice” is being used by the Conservatives as a smokescreen for the promotion of competition at the expense of co-operation and integration. III. the NHS in England is being floated off into independent buyers and providers of care divorced from the state and from political accountability, and that £80 billion of tax-payers money is to be spent with little or no direct political accountability at local or national level. Conference believes: A. that a competitive market is not an appropriate model for delivering healthcare in the UK, nor one that the Liberal Democrats can help to bring nearer. B. that Liberal Democrat MPs and peers should not be whipped to support Conservative policies that go beyond the coalition agreement and which have been rejected by our conference. Conference therefore for calls for the bill to be amended by: 1. the removal of all references to promoting competition whether directly or indirectly. 2. any duty to promote choice being made subsidiary to duties to promote fair access, equality of outcomes, and integrated services. 3. the removal of the facility for transferring NHS assets, including land, to third party providers. 4. retaining the cap on Private patient income by NHS Foundation trusts. 5. the restoration of the duty of the Secretary of State to provide or secure the provision of, healthcare services, and the reinstatement of the power of the Secretary of State to delegate his functions to NHS commissioners and to direct them as necessary. 6. the retention of the ability of the local authority overview and scrutiny function to refer significant services changes to the Secretary of State for adjudication. 7. providing that Health and Well-being Boards (HWBs) have a majority of elected members and are able refer unresolved disputes with local commissioners to the Secretary of State rather than to a national qango. 8. the explicit prohibition of the wholesale outsourcing of commissioning work to private companies. 9. guaranteeing that commissioning groups are fully co-terminous with social services local authorities, except where HWBs and local authorities agree otherwise, and are funded solely on the basis of the health needs of the population. 10.the removal of the power to pay financial incentives to practitioners as a means of influencing their referral behaviour. 11.rejection of any personal health budget scheme which allow users to spend NHS funds on private health insurance or as a top up towards private health care or to buy services or treatments judged too ineffective or inefficient for the NHS to buy. 12.the inclusion of a duty on all NHS bodies, when arranging with non-NHS bodies to provide services, to avoid any risk of essential NHS services (including teaching and research) being destabilised in an unplanned way through loss of income or case-load, and 13.ensuring Directors of Public Health remain independent sources of expert advice. and further calls for the active support of these objectives, as party policy, by Liberal Democrat Parliamentarians and, in the absence of all of these changes being made, calls for Liberal Democrat Parliamentarians to reject the Health and Social Care Bill in its entirety.

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