Independent Parliamentary Standards Authority

Proposed by Margaret Greenwood

I beg to move, That leave be given to bring in a bill to re-establish the Secretary of State’s legal duty as to the National Health Service in England and to make provision about the other duties of the Secretary of State in that regard; to make provision about the administration and accountability… I beg to move, That leave be given to bring in a bill to re-establish the Secretary of State’s legal duty as to the National Health Service in England and to make provision about the other duties of the Secretary of State in that regard; to make provision about the administration and accountability of the National Health Service in England; to repeal section 1 of the National Health Service (Private Finance) Act 1997, sections 38 and 39 of the Immigration Act 2014 and Part 9 of the Health and Social Care Information Act 2012; to make provision about the application of international law in relation to health services in the United Kingdom; and for connected purposes. It is a privilege to have the opportunity to present this Bill to the House. I pay tribute to the many patients, nurses, doctors, trade unions and campaigners across the country who have been working tirelessly to combat the privatisation of our national health service. I also pay tribute to my hon. Friend the Member for York Central (Rachael Maskell) and the hon. Member for Brighton, Pavilion (Caroline Lucas) for the work that they have done. The Bill is intended to fully restore the NHS as an accountable public service by reversing marketisation in the NHS, abolishing the purchaser-provider split, ending contracting, re-establishing public bodies and making public services accountable to local communities. The Health and Social Care Act 2012 provided the framework for the privatisation of the NHS, and we are seeing that privatisation happen at pace. I believe that the Act brought in three core changes that are driving that privatisation. First, it removed the legal duty on the Secretary of State for Health to provide and secure a comprehensive national health service in England. Secondly, it included a requirement to put NHS contracts out to competitive tender in the free market, putting the profit motive at the heart of the service. Thirdly, it allowed NHS hospitals to make up to 49% of their money out of private patients. The Bill makes the case for a planned, managed health service. It would reinstate the duty of the Health Secretary, lost under the 2012 Act, to provide a secure and comprehensive NHS. That is important because, under the current arrangements, clinical commissioning groups do not have to serve a particular geographic area and are not required to tend to all illnesses and conditions. In some areas, certain treatments, such as hip and knee replacements and cataract operations, are already being rationed. Reinstating the Secretary of State’s duty is vital to provide the Government accountability needed to maintain a comprehensive NHS. The 2012 Act forces NHS contracts out to competitive tender in the marketplace, allowing private companies to cherry-pick NHS services from which they can make money. Since 2012, we have seen the effect of NHS contracts going to private companies—it undermines NHS services and the pay and conditions of staff and fragments the service. The sums of money involved are eye-watering. The Government would have us believe that only 6% of contracts go to private firms, but according to the NHS Support Federation, private firms won 36.8% of contracts in 2014-15, securing £3.54 billion of the £9.628 billion of deals awarded. Does that matter? I say yes, absolutely, without question. Contracting out is very expensive. In the USA, the cost accounts for about 30% of healthcare expenditure, compared with 5% in the non-marketised NHS pre-1990. Any private company has a duty to generate profit for shareholders, but the money we pay through our taxes should be spent on patient care and should not go to shareholders. Putting healthcare contracts out to competitive tender means money being spent on marketing and contract lawyers that could be spent on patients. A proliferation of providers also means a proliferation of administrative costs and opens up opportunities for fraud. The only way the private sector can reduce costs is ultimat

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