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Conservative election poster 2010

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

The gathering storm of autumn cuts / Features / Home – Morning Star

We may be entering the summer silly season for news, with the NHS barely visible in the papers and forgotten by broadcasters.

But don’t be fooled – brace yourself for an autumn of massive cuts as NHS bosses draw up plans to slash each area on an unprecedented scale.

More than half of all senior NHS managers are worried that patients’ access to care will be cut back as a result of a tightening financial situation, which 42 per cent of them described as the “worst they had ever experienced,” according to a recent survey by the NHS Confederation.

Thirty-nine per cent of NHS chairs and chief executives expected financial pressures to increase over the next three years, while 75 per cent felt cuts in spending on social services by local councils would also impact on health services.

Analysts are now warning of a new ice age in NHS funding, with budgets growing little, if at all, even after 2015.

These findings came less than a month after David Cameron, seeking to smooth the way to push through Andrew Lansley’s microscopically modified Health and Social Care Bill, went on record with five pledges on the NHS, one of which was that “we will not cut spending on the NHS – we will increase it.”

Dave Prentis: Our National Health Service in Peril

Our National Health Service celebrated its 63rd birthday last week. I think it’s been one of the great success stories of the past century – an institution dedicated to treating the sick, relieving suffering, and saving lives, regardless of ability to pay.

Apart from the fact that the NHS is there for everyone when they need it, I have reason to be grateful to this fantastic service. It saved my life when I was diagnosed with advanced stomach cancer some years ago. And I want the NHS to be there for generations to come.

To mark the anniversary, I delivered a giant birthday card to the Department of Health, along with other trade union leaders. And later we lobbied Parliament to ask them to join us in wishing the NHS Many Happy Returns. This was not just a celebration of 63 years, but an impassioned plea to our politicians to make sure that the world’s largest and best publicly funded health service is not dismantled.

For that is what I fear will happen if the Frankenstein Health and Social Care Bill is passed into law. The LibDem arm of the coalition Government has made a great deal of noise, belatedly, about the changes it has wrung from its Tory partners to sweeten what will be a bitter pill. But, those changes are just not enough to prevent our NHS being dismantled or to save it from those who want to make a profit out of the sick.

Lansley ‘increasing NHS bureaucracy’: ePolitix.com

Labour has accused the government of increasing rather than cutting NHS bureaucracy.

Speaking in the Commons this afternoon shadow health secretary John Healey said: “In spite of the spin the truth is the prime minister’s personal promise to give NHS a real rise in funding is being broken.

“It’s not just how much it’s how well the money is spent, and today Mr Speaker is one year to the day the health secretary launched plans to ‘liberate’ the NHS.”

Healey said that rather than phasing out top down hierarchy and reducing the cost of NHS related quangos, Lansley had overseen the creation of a lot more bodies.

He questioned why Lansley was setting up the National Commissioning Board which was set to employ 3,500 people.

And he asked why the government was setting up 500 public bodies in the NHS when 161 “do the job now”.

“Why is govt wasting precious NHS funding on the biggest reorganisation in its history it should be spent on patient care,” he said.

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There is a great deal of NHS news today so I’ve tried to impose some order out of chaos™.

  • There are many articles about the 63rd birthday of the NHS yesterday.
  • Health Secretary Andrew Lansley was evasive while appearing before the Health Select Committee hearing yesterday. Lansley reveals that the bill does not address competition law which is left to be decided by the courts.
  • Waiting times and cuts are to increase despite Prime Minister David Cameron’s commitments that they would not.
  • Massive increase in NHS bureaucracy as a result of NHS reforms despite the claimed intention of the reforms to reduce bureaucracy.

Conservative election poster 2010

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

NHS 63rd Birthday

Happy birthday NHS / Britain / Home – Morning Star

TUC general secretary Brendan Barber said: “Despite some amendments to the controversial NHS reforms, many of the most damaging aspects of the Health and Social Care Bill remain. The changes presented to us by the government after its recent listening exercise amount to little more than smoke and mirrors.

“The government’s proposals go against the very principle of our NHS, in which care is based on need not ability to pay.

“They mean private providers will be able to increase their role in the NHS, simply cherry-picking the most lucrative parts for their own private profit to the detriment of the overwhelming majority of patients.”

Happy 63rd Brithday NHS

Rehana Azam GMB National officer for NHS said “GMB wishes the NHS a happy 63rd birthday today.

The Tory plan is to get the guts of the measures on the statute book and then by stealth break up the National Health Service.

The NHS was designed to be a cradle to the grave health and care service free at the point of use until the Tories in 1990 changed it to be a cradle to nursing home service. That is what people want and that is what politicians should respect and deliver.”

Campaigners celebrate 63 years of NHS – Local news – Worksop Guardian

Spokesperson for Bassetlaw Protecting our People and Services group Ann Donlan said: “Before the NHS they had to pay for medicine, pay for doctors and pay for treatment.”

“Since the NHS came in we have had first class service and an excellent hospital. We are here to remind people of its importance, we do not want to see it privatised again.”

Spokesperson for Bassetlaw Protecting our People and Services group Ann Donlan said: “Before the NHS they had to pay for medicine, pay for doctors and pay for treatment.”

“Since the NHS came in we have had first class service and an excellent hospital. We are here to remind people of its importance, we do not want to see it privatised again.”

Birthday cake and banners at NHS protest over reforms – Health – The Star

Campaign member Andy Turner said: “It is clear that the Department of Health is planning for the Health Bill to go through largely unchanged. It has clearly been a cynical exercise to take the heat out of the situation.

“We are gravely worried that the proposed changes will favour private healthcare providers accountable to shareholders and not patients, promote competition and not co-operation, and lead to drastic reductions in quality of patient care.”

Increased Bureaucracy

Leaked paper says new NHS board with £20bn budget will direct health reforms | Society | The Guardian

A new NHS commissioning board employing 3,500 staff and with a £20bn commissioning budget will oversee the government’s reforms to the health service, according to a leaked Department of Health document.

Labour said the document showed the government was planning to create a new layer of NHS bureaucracy, raising questions about the health secretary Andrew Lansley’s claim to be streamlining the management of the health service.

The document, which carries a warning “confidential draft – not for circulation” – was drawn up by the NHS chief executive, Sir David Nicholson, as he outlined the duties of an independent NHS commissioning board.

Nicholson said the new board will:

• Employ about 3,500 staff. It will have a chair and five non-executive directors. A chief executive will head a team of five executive directors – the four others will be a nursing director, a medical director, a director of commissioning development and a director of finance, performance and operations

• Directly commission £20bn of services and hold about 33,000 contracts for primary care services

• Oversee the new clinical commissioning groups across the country that will take responsibility for £80bn of the NHS budget.

England will be split into four “commissioning sectors” – with London as one of the “distinct” areas, raising questions about whether strategic health authorities are being reconfigured.

Nicholson proposed that the new board should be called NHS England, though he admitted that this might be a step too far.

The chief executive added in his report that his proposals would lead to savings because the board’s 3,500 staff would take over the duties currently performed by 8,000 workers.

Liz Kendall, the shadow health minister, said: “The government is wasting precious NHS resources on its huge re-organisation.

“Their original plan was going to cost at least £2bn. Their new plan will cost even more as the number of NHS organisations balloons from 160 to more than 500.”

Kendall also criticised Simon Burns, the health minister, who told the Commons committee examining the health and social care bill that it was premature to comment on staffing levels.

She added: “Today the minister Simon Burns told me it was ‘premature’ to say how much their new super quango, the NHS commissioning board, will cost and how many staff it will employ.

“Yet we now know from this leaked document it will employ at least 3,500 staff. The government must now come clean and spell out the true costs of their chaotic NHS plans.”

“Massive bureaucracy” increase due to Health Bill » Hospital Dr

The government’s NHS reforms are set to treble the number of statutory NHS organisations, the Royal College of GPs’ chair Dr Clare Gerada warned MPs.

Giving evidence to the Parliamentary Health and Social Care Committee last week, Dr Gerada warned the reforms will send the number of statutory NHS organisations soaring from 163 to 521.

Gerada complained that NHS bureaucracy was being “massively increased”, while the revised bill had become “very incoherent”.

“It is neither liberating nor controlling. It neither allows for GPs to be innovative, nor does it give them tight restraints.”

The RCGP’s tally of new quangos includes 300 commissioning groups, 150 health and wellbeing boards, 50 PCT clusters, 15 clinical senates, four SHA clusters, the National Commissioning Board and the Department of Health.

Gerada said: “We are deeply concerned that commissioning consortia are going to be so bound up in bureaucracy that they will simply not be able to deliver the system leadership required.”

Cuts and related Increased Waiting Times

Managers warn of worsening access to NHS care – Main Section – Yorkshire Post

PATIENT access to NHS care will worsen in coming years as the health service faces “unprecedented” financial pressures, health bosses warn today.

In a survey of nearly 300 chief executives and chairmen, four in 10 say the financial situation facing their organisations is the “worst they had ever experienced” and another 47 per cent say it is “very serious”.

More than two thirds fear the pressures will intensify over the next three years, partly due to the impact of cuts by local councils, and that waiting times will worsen.

In a stark message, NHS Confederation chief executive Mike Farrar will today tell the annual conference of managers in Manchester that key decisions taken in the next 18 months over future health service reforms would determine “if the NHS is a going concern for future organisations to inherit”.

related: BBC News – NHS chiefs warn of rising hospital waiting times Pledges on NHS waiting times in doubt | Society | guardian.co.uk Spending cuts will mean longer waiting times, say NHS managers – UK Politics, UK – The Independent


Irritated MPs interrogate Lansley over NHS Bill / Britain / Home – Morning Star

Frazzled MPs spent a frustrating two hours today trying to cajole Health Secretary Andrew Lansley into revealing how much competition will be unleashed in the NHS.

Mr Lansley went round in circles before grudgingly admitting to Lib Dem MP Andrew George that many of the amendments to the Health and Social Care Bill were cosmetic.

Some amendments were introduced to address “misplaced concerns,” while others were to “reflect more accurately” the principles proposed in the Bill, explained the minister.

“Some of them are genuine changes,” he added chirpily in an appearance before the health select committee.

Parrying questions on the changes, he insisted: “It was not recommended to us by the NHS Future Forum that we should depart from the principles of the Bill.”

The forum had said that there was “widespread support” for the measure, he crowed.

Labour MP Valerie Vaz joined West Cornwall Lib Dem Mr George in trying to smoke out the minister over his latest emphasis on giving wide powers to a NHS National Commissioning Board, charged with promoting “integration” and improving quality.

NHS chief executive Sir David Nicholson confessed that the enhanced National Commissioning Board did not actually have any members yet.

“It’s just me at the moment,” he said.

There was a lot of “preparatory work” to do and adverts for a chair and a non-executive director would appear after the summer break.

Playing with words, Mr Lansley declared that NHS regulator Monitor would in future be using competition “as a means to an end” rather than the earlier intention of promoting competition as “an end in itself.”

HealthInvestor – Article: NHS competition rules ‘still open to debate’, admits Lansley

There remains a lack of clarity about how competition law will be applied in the reformed NHS, the health secretary has admitted.

Speaking at a Health Select Committee hearing, Andrew Lansley said the full application of competition law in the health service would be determined gradually by the courts, rather than by his amended Heath and Social Care Bill.

“If you’re trying to establish with certainty what the boundary of the application of competition law is, then it’s a matter of debate and it will be something that will only be determined over time as there are cases brought before the courts,” he said.

At present, EU competition rules only apply to ‘undertakings’, meaning enterprises engaged in ‘economic activities’. This means that while it applies to private providers in the NHS, it tends not to cover public sector bodies. There remains considerable legal debate about what constitutes an ‘economic activity’ in public healthcare provision, especially amid efforts to introduce a genuine internal market within the NHS.

The health minister, giving evidence on the government’s response to the NHS Future Forum report, said clarity on competition law was not contained within his amended Health Bill and would only emerge as providers challenged decisions in the courts.


27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

Please be assured that this blog is a non-commercial blog (weblog) which does not feature advertising and has not ever produced any income.


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NHS news review EXTRA: NHS Birthday

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The NHS is 63 today. Health professionals are united in their opposition to the ConDem coalition government’s Health and Social Care Bill which has the intention of destroying the NHS.

UNISON Press | Press Releases Front Page

UNISON General Secretary, Dave Prentis, delivered a giant birthday card to the Department of Health today (5 July), to mark 63 years since the NHS was founded.

The chief of the UK’s largest union, joined other union heads and health workers, to warn the Government that the NHS would not make its 64th birthday if plans set out in the Heath and Social Care Bill go ahead.

The plans will lead to the break-up of the NHS and private companies grabbing huge chunks of the NHS birthday cake.

Across the UK, health workers and members of the public are also hosting birthday events and campaigning against the reforms.

Dave Prentis said:

“For 63 years doctors, nurses and other health workers have made the NHS the national treasure it is.

“Now the Government is trying to destroy the health service and open it up to private companies, who will put patients before profits.

“The Bill should be binned and started from scratch, as it is a recipe for disaster.

“The NHS must be safeguarded, so it can celebrate its 64th birthday.”

The card, which was signed by the TUC General Council and senior union officials, along with many members, said:

“We need to safeguard the future of the health service for generations to come.

The greeting inside the card reads: ‘The Health and Social Care Bill sets out hugely damaging changes to the NHS. We are worried that they could mean taxpayers’ money for the NHS diverted to big business, and competition instead of the increased collaboration patients need. We want to safeguard our NHS and make sure that there is a 64th birthday to celebrate too.”

Happy 63rd birthday NHS – Royal College of Midwives

RCM general secretary Cathy Warwick this morning joined representatives from the TUC and unions representing health workers, and helped hand deliver a giant birthday card to the Department of Health to celebrate 63 years of the NHS.

The card will be delivered to health secretary Andrew Lansley at Whitehall. Carrying a four-foot card, the union leaders will highlight concerns that the changes the government is proposing in the Health and Social Care Bill will fundamentally undermine the founding principles of the NHS.

Cathy Warwick said: ‘The NHS is a national treasure and should be protected not dismantled. Midwives are some of its many unsung heroines. They work long hours because they want to be with women before, during and after childbirth. The erosion of midwives’ pay and conditions, however, is making working conditions unsatisfactory for midwives because they are not able to give the care they want to women.

‘Meanwhile, there are not enough midwives to deliver the care that women need now. I have real fears that maternity care could suffer as trusts struggle to cope with health reforms and the profound change in its structure.’

Listen to Cathy Warwick talking about delivering the card and her concerns about the Health Bill in the RCM Communities vlog.

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Celebrations of the 63rd birthday of the NHS today are concerned for its future. The TUC highlights concerns about the Health and Social Care Bill (Destroy the NHS Bill) while Ozzy Osbourne pays tribute to the NHS and says that without the NHS’s dedication he could not have continued his career as the Prince of Darkness.

Conservative election poster 2010

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Trades Union Congress – Campaigners celebrate the 63rd birthday of the National Health Service

Despite the government’s response to the recent NHS Future Forum report, unions still have key concerns about the Health and Social Care Bill. These include fears about a vast and damaging extension of competition, and concerns that the abolition of the private patient income cap will see NHS patients pushed to the back of the queue as waiting lists grow and trusts prioritise care for paying patients.

Unions also have concerns relating to the clinical commissioning process. Many groups of staff will still have no voice within the process and it is also likely to mean mass subcontracting to private companies, and an overly complex system at local level.

Transparency and accountability remain a concern. Although the Bill requires trusts to hold their meetings in public, no such requirement will exist for private and voluntary sector providers of health services.

Commenting on the birthday celebrations, TUC General Secretary Brendan Barber said: ‘Despite some amendments to the controversial NHS reforms, many of the most damaging aspects of the Health and Social Care Bill remain. The changes presented to us by the government after its recent listening exercise amount to little more than smoke and mirrors.

Ozzy in tribute to ‘dedicated’ NHS – Scotsman.com News

The former Black Sabbath frontman, who was born five months after the service was created on this day in 1948, was one of the first generation of NHS babies.

The singer was also treated by NHS staff in 2003 after a near-fatal accident at his Buckinghamshire home left him with a fractured neck vertebra, eight fractured ribs and a broken collarbone.

He said: “If it wasn’t for the hardworking staff of the NHS following my serious quad bike accident, I may not be here today to continue my career as the Prince of Darkness.

“I want to say a big thank you to all of the dedicated doctors, nurses and everyone else who makes up the NHS across the country – from Birmingham to Berkshire. Just like me, it’s still going strong after 63 years. Long may we both keep it up.”[!]

Britain/Health service – An update on the British government’s piecemeal privatisation of healthcare

[NB This is a long article very useful for background]

[9.45a.m. 5/7/11edit:  This article while mostly accurate is partly outdated by changes following the Future Forum’s ‘listening exercise’

e.g. this section is outdated re: exclusion of hospital doctors and nurses

Instead the Bill proposes that £80 billion of commissioning budgets are to be devolved to local consortia of GPs, which will decide how best to spend the money. The Bill lays down no specific requirements in terms of the size of population to be covered by a consortium, the organisational structure of a consortium, or for any public or non-GP involvement. The Bill specifically excludes hospital doctors however senior, and nursing staff and other health professionals from any specific role in this new management structure.]

The situation in England’s health care system reflects the broader picture on the European and a world scale. Healthcare is the world’s biggest industry with a turnover in excess of $5 trillion annually, 85% of which is spent in the wealthiest countries, in most of which the majority of spending takes place through tax funded systems all through social health insurance. The private sector, looking to rebuild its profit margins, is determined to recapture a larger share of this health budget, especially in Europe.

But because of the political obstacles to most European governments being seen to break up and privatise healthcare systems, which currently deliver near- universal care – in general with few copayments or charges at point of use – the privatisation process has been of a special kind.

This is very different from the process of privatisation in the UK and in other countries in the 1980s, in which whole utilities such as gas and telecoms and electricity were sold off to shareholders and became private for-profit businesses.

There are three reasons for this: the first is the political sensitivity of the issue for parties, which in general are trying to appear different from the old style Thatcherite neoliberal parties of the 1980s: and in a political climate in which there is little sympathy for the private sector and privatisation.

The second rason is that the private sector itself has limited interest in taking over the whole of healthcare systems: their focus is primarily on cherry picking those parts of the system which appeared to offer them a profit, primarily uncomplicated elective surgery – the mainstay of private medicine around the world. Certainly in England there has been very little pretence from private sector companies of any interest in taking over for example work on accident and emergency services, complex and risky surgery, or chronic care for older people and community services of any type.

And finally there is the issue of resources in the private sector: healthcare systems are far larger than the utilities of the 1980s, while the private health care sector is centred on small-scale hospitals and providing services to an elite wealthy minority of the population: it therefore has nowhere near the management or capital resources required to contemplate a takeover of the entire health systems.

In England the process of slicing off particular sections of health care for privatisation began in the mid-1980s with Margaret Thatcher’s government deciding to put non-clinical hospital services such as cleaning, catering, porters and other services out to competitive tender. The result of this was to stimulate the emergence of a new range of small-scale and untested private companies, and in the context of labour intensive and generally low paid work, these companies attempted both to undercut existing costs to win contracts and at the same time make a profit focused on employing fewer staff, working harder, and offering them worse pay and conditions.

This in turn brought the virtual casualisation of hospital cleaning in much of the UK, but also undermined staffing levels and standards of cleaning and hygiene, even in those hospitals where services remained in-house, since public sector managers were obliged to compete with the low standards and low wages of the private sector.

A generation later the legacy of this privatisation is still haunting the National Health Service in much of the UK, and especially in England, where fewest services have been brought back in-house in recent years. Hospital-borne infections, poor standards poor morale and gaps in staffing levels continue to create problems and often to dump work which should be done by private companies onto nursing and other staff who have other responsibilities as well.

BBC News – Social care costs ‘should be capped at £35,000’

Social care costs in England should be capped so people do not face losing large chunks of their assets, an independent review says.

Council-funded home help and care home places for the elderly and adults with disabilities are currently offered only to those with under £23,250 of assets.

The Dilnot report said the threshold should rise to £100,000 and a £35,000 lifetime cap on costs would be “fair”.

UNISON Press | Press Releases Front Page

UNISON, the UK’s largest union, said today that the Dilnot Commission’s report could be a stepping stone in the right direction towards an NHS style model of care for the elderly, free at the point of use. Raising the means-testing threshold and capping private contributions draws a line in the sand, but the public will want to see that cap move downwards towards tax-funded care, otherwise it will always be a hostage to political fortunes.

The union called on the government to act now on the recommendations, making sure every penny goes towards public care not private profit, and urged it to tackle the wider issues of quality in the system. And warned that public trust in an insurance based model will be low, given the poor track record of the financial services industry.

Healthcare Locums probes two execs over ‘misconduct’ | Business

Two senior recruiters at crisis-riven healthcare employment agency Healthcare Locums have been suspended pending investigations into serious misconduct allegations that will fuel criticism of the use of profit-driven private contractors by the NHS.

One executive, Christian Mansfield-Osborne, is being investigated for alleged “irregular invoicing” in an affair which has involved the company reimbursing one NHS trust in Birmingham with £200,000.

The other, Scott Whitehead, is being probed over allegations that ancillary staff were sent out to work for the NHS without having undergone the required checking procedures.

It is not clear which checks were allegedly not carried out, but the kind of paperwork required for such contractors include Criminal Records Bureau searches, right-to-work documentation and professional qualifications.

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Conservative election poster 2010

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Union draws up NHS wish list / Britain / Home – Morning Star

Unison general secretary Dave Prentis will urge the government to pick presents from the union’s wish list for the NHS’s 63rd birthday tomorrow or the health service may not be celebrating next year.

Mr Prentis will warn the government that unless it takes heed of the wish list, plans set out in the Health and Social Care Bill will lead to the break-up of the NHS.

Profits will be put before patients, as private companies are set to gnaw through a huge slice of the birthday cake.

Mr Prentis will join other union heads at the Department of Health at 9.30am to present giant birthday cards.

“For the last 63 years hard-working health service staff have saved millions of lives and built it up to be the national treasure it is today. The government wants to tear all this down and turn the NHS into little more than a logo,” he said.

“The best present the government could give is to recognise the good work carried out by doctors, nurses, cleaners and other health staff. By picking the presents laid out in our birthday wish list it could stop the Health and Social Care Bill becoming a recipe for chaos and privatisation.

“Plans set out in the Bill will simply turn the NHS into a business, where more of our taxes will pay for profit-driven companies to provide our health care.

“All of this when satisfaction of the NHS is at an all-time high.

“NHS staff, campaigning groups and the public will fight to keep a service that puts patients before profits. We must stop a similar crisis to Southern Cross and make sure that there is a 64th birthday to look forward to.”

UNISON Press | Press Releases Front Page

UNISON’s NHS birthday wish list:

Keep services in the public domain – the move to a policy of ‘Any Qualified Provider’ will see private companies get their claws into services – it will then be impossible to bring them back. New commissioning consortia will outsource to unaccountable companies, while the NHS will be legally blocked from being the ‘preferred provider’ of care.

Retain the cap on private patient income – the existing cap is designed to stop Trusts prioritising more profitable private patients over those in the NHS. As waiting lists continue to grow, NHS patients will be pushed to the back of the queue. The NHS is built on fairness and equity – this policy exemplifies the Government’s disdain for its founding principles.

Halt the move to make Monitor an economic regulation – despite claiming to have ‘listened’ to the barrage of criticism, the government still envisages the regulator Monitor as an NHS version of Ofgem or Ofwat, with the power to enforce competition law and prevent “anti-competitive behaviour”. This will move the focus away from scrutinising the quality of care, potentially putting patients in danger.

Keep staff in their jobs – the Government’s own figures anticipate 20,000 redundancies across the NHS – patient services are bound to suffer. Redundancy payments alone will cost £1bn, which is a colossal waste of money when the NHS is under huge pressure to make ‘efficiency savings’ elsewhere.

Strengthen accountability and openness – the Government still plans to put responsibility for the NHS at arm’s length from the health secretary, meaning that Parliament will find it harder to hold the NHS to account. Loopholes will allow commissioning consortia and foundation trusts to block the public from full access to their meetings and decision-making processes.

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