What the new Health and Care Bill means for the NHS and future privatisation
As the NHS prepares to face its toughest winter on record, the government has just passed a new Health and Care bill that will usher in a huge reorganisation of the health service
Despite following one of the most difficult periods in the health service’s history, at a time when the NHS faces its worst winter crisis on record and has a waiting list of over 6m patients, the bill does nothing to cut wait times, boost staffing levels, or put any money towards helping the 2,000 elderly people whose requests for care are refused every day.
Initially intended to combine social care with health and include local authorities, it was hoped that the bill would make adult social care free at the point of use and force the NHS and local authorities to pool their resources.
However, it’s changed quite a lot from its initial inception – leading to criticism from frontline NHS staff as well as a number of MPs and campaign groups, who say that the bill opens up the NHS to further privatisation.
Will the new Health and Care bill privatise the NHS?
A Unite spokesperson told The Big Issue earlier this month that the bill will bring about a ‘complete break up of the NHS as we know it’.
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The new bill effectively divides the single, central, and public National Health Service into 42 independently-run parts, allowing private companies to make decisions about public spending and health services for the first time in its history.
By making space for private firms on these newly-created boards, corporate interests will be given a vote on how health and social care is prioritised in each area of the country – leading to concern that profit motives could override public needs, not to mention the potential for conflicts of interest in the awarding of contracts.
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Doctor-led campaign organisation EveryDoctor tweeted that the new bill will ’embed private companies in the NHS in England – giving them the power to decide who gets what treatment when’.
Pointing out that 11% of the NHS budget already goes to private companies, campaigners added: “No one should be profiting from public healthcare, it’s as black and white as that.”
Does the bill enable ministers to interfere in the day-to-day running of the NHS?
The bill gives greater powers over the NHS to Sajid Javid, the Secretary of State for Health and Social Care, and creates scope for greater political interference in day-to-day decision making.
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There are concerns around this, as Mr Javid has previously questioned why people ‘go to the state’ for health care and said that they ‘have to take some responsibility’ too.
When he laid out his vision for the NHS at the Conservative party conference earlier this year, he said: “The state was needed in this pandemic more than any time in peacetime, but government shouldn’t own all risks and responsibilities in life.
“Health and social care it begins at home. It should be family first, then community, then the state.”
The new bill requires the Secretary of State to be notified of any and all proposed changes, dramatically reducing the ability of the NHS to manage its services day by day.
A report by The Kings Fund examining the bill concludes that this places ‘a significant burden on local and national NHS bodies awaiting decisions – and delaying changes to services that clinicians have already concluded would benefit patients’.
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It adds: “Affording such broad powers to the Secretary of State is at odds with the stated intent of the reforms to reduce bureaucracy and empower local decision-making.”
How does the bill address the big challenges facing the NHS right now?
Workforce shortages are one of the biggest challenges facing the sector right now, with staff across both the NHS and care sector currently experiencing high levels of stress, absenteeism and turnover.
However, the bill does very little to address these challenges – and only requires the Health Secretary to report ‘at least every five years’ on workforce needs.
Whilst integrating the system is key to providing better joined-up care, measures relating to the workforce have been criticised as ‘weak’ by the The Kings Fund, with the organisation adding that Sajid Javid ‘could wait until 2027 to produce such a report’.
Instead, it’s called for a “fully funded workforce strategy that addresses staff shortages, boosts retention by improving working cultures and includes a renewed commitment to providing compassionate and inclusive leadership.”
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How does the bill affect duties to provide hospital care and patient treatment?
Some experts have warned that the wording of the bill does away with the statutory duty to provide hospital care, meaning that if the bill passes through the House of Lords the NHS will no longer be obliged to care for people in a hospital setting.
Lawyer Peter Roderick and public health doctor Allyson Pollock both say it removes the current legal duty to look after people in hospital.
This also means that options for legal action when care is denied will be withdrawn, as the new bill provides no right to care in the first place.
Each of the 42 new bodies will be given strict budgets, meaning that decision-making powers will ultimately be limited to the short term.
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There is some concern that these strict spending limits could lead to longer wait times on care once the money runs out, leading to a potential postcode lottery as services and standards will be dictated by where you live.
Ultimately, the bill means that health care will differ for patients across postcodes as all decision-making will be centered around the needs of the local population with boards deciding what services to offer and what to omit.
How will the new bill benefit patients?
In theory, if the reforms succeed in creating an environment where separate organisations can work together more collaboratively, patients with multiple health issues could see a move towards joined-up care where the wider factors that influence health and wellbeing are taken into account.
Currently, services are provided by a range of different organisations that sometimes work together well but other times do not.
In the future, it is hoped that that bill will enable NHS organisations, local authorities, social care providers, VCS organisations, community leaders and others to work together on long-term health plans – but only time can tell on this.
Strangeways declared ‘threat to national security’ following drone deliveries of drugs, weapons and more
Danny Jones
A recent trend at HMP Manchester has been declared a “threat to national security” after it was learned that drones have been regularly delivering drugs, weapons and more into the facility formerly known as Strangewaysalong with other UK prisons.
It’s said there were roughly 220 drone sightings over the past year or so – more than any other prison in the country – and issues around contraband, violence, hygiene and more have been on the increase ever since. HMP Long Lartin in Worcestershire was found to be similarly neglected.
A rife drug and rat problem was found following a surprise autumn inspection between September and October; it is now evident that the chronic issues have been exacerbated by a major security breach as His Majesty’s Chief Inspector of Prisons, Charlie Taylor, says police have “ceded airspace” over facilities.
The most recent report on conditions at HMP Manchester and Long Lartin was published on Tuesday, 14 January and, in short, it insists that huge investment is needed in order to curb the crisis.
Credit: HM Inspectorate of Prisons
Drones, corruption and a lack of investment have seen Strangeways maintain its reputation
A top-line assessment of Strangeways found that many of the sticking points came down not only to the advent of drones delivering items such as phones, drugs, weapons and other “large payloads” weighing up to as much as 7kg, but merely “poor physical security” and concerns regarding corruption.
Most notably, high-risk prisoners who Taylor described as “extremely dangerous” have been burning holes in cell windows in order to pick up drone deliveries. The ease with which these exchanges are able to take place comes down to what he simply calls “slow action”.
There has been a damning failure to spot, repair and/or replace these panels, as well as the torn netting over exercise yards, meaning that drone operators have an easier task when dropping their packages into the 158-year-old penitentiary.
According to the report, “a staggering 39% of prisoners had tested positive in mandatory drug tests at Manchester” (50% at Long Lartin) and a simple survey found that drugs and alcohol were “easy” to acquire inside Strangeways.
In addition to the rodent infestation, general hygiene looks to have plummeted to new lows in recent times too, with “widespread dirt, damp and litter” as well as vandalism in several areas. Inmates have also been tearing up mattresses to insulate windows from the cold.
Numbers relating to assault, self-harm, suicide and more have also risen since the last major inspection in 2021. By all accounts, it remains one of Britain’s most dangerous prisons for a whole host of reasons.
There has also been a significant drop-off when it comes to socialisation and rehabilitation efforts, as the work day, learning and general activities look to have dwindled too.
Taylor signed off by writing: “The safety of staff, prisoners and ultimately that of the public, is seriously compromised by the failure to tackle what has become a threat to national security.
“The prison service, the police and other security services must urgently confront organised gang activity and reduce the supply of drugs and other illicit items which so clearly undermine every aspect of prison life.” To put it simply, he says the situation is “highly alarming.”
It may not make for pleasant reading, but if you want a clearer picture of the current conditions inside Strangeways prison or to learn more about the growing advent of smuggling drones, you can read the extensive 67-page report in full HERE.
Broken cell windowDamage and dirtThe state of a kitchenette (Credit: HMIP)
Featured Images — Robert Wade (via Flickr)/HMIP (HM Inspectorate of Prisons)
UK News
Government to introduce price cap on ticket touts and launch consultation on dynamic pricing
Danny Jones
The UK government are finally set to install a price cap on re-sale tickets for touts and open an official consultation on the growing trend of dynamic pricing.
If you’ve bought a ticket to a live music show over the past year or so, you’ll have noticed that ticket prices in general are on the up – particularly if purchased from a reseller, in which case you might have paid through the nose for the privilege.
Not only does ticket touting remain a prevailing problem in the industry, with tonnes of tickets for big shows, especially, being snapped up in bulk or by bots and listed for re-sale before you’ve even added them to your basket, but the advent of this new dynamic pricing lark has made things even harder.
You only have to look at the controversy and chaos surrounding Oasis’ reunion tour, which ultimately saw some fans paying significant amounts more for practically the same ticket just a few days later in what many dubbed as ‘fraud’ and even ’emotional blackmail’.
Justin Timberlake at Co-op Live Manchester was one of countless gigs where ticket prices fluctuated. (Credit: The Manc Group)
Tackling resellers head-on
Knowing full well that people will go to extreme lengths to try and see the musicians and artists they love so dearly – in some cases being backed into a corner as the final figure displayed on the screen when they checkout suddenly jumps up – the modern ticketing industry is severely broken.
With all that in mind, the government are now looking to enact more stringent measures on resellers, by announcing a new price cap on tickets put back up for sale which is set to be introduced (hopefully) in the very near future.
Targeting sites infamous for inflating re-sale costs such as Viagogo, StubHub and others, the bill published on Friday, 10 January proposes a price cap of face value plus 10-30% but no more, with an obvious aim to keep that number as low as possible.
According to the current figures, touts reportedly cost music fans alone more than £145 million in extra re-sale fees when purchasing tickets every year – a frankly ridiculous sum. There will always be tickets ending up on re-sale sites, that’s unavoidable, but a price cap could seriously improve the situation.
The Manc music legends themselves claim they had little control over the situation.
Down with dynamic pricing
Labour, who were voted into power back in July, are also set to try and combat dynamic prices, which essentially sees gigs and events set people back more or less depending on how the popular ticket sales have been up to that point, market trends and general demand. An initial review was called for last year.
Put simply, the more people want to attend a gig, platforms like Ticketmaster feel they are able to jack up their margins even after the initial price point has been established. The European Commission has been investigating these methods since September 2024.
Although it is still unclear as to the exact time scale of when these changes will come in, Labour MP Chris Bryant told NME that although they are still in the early stages, it is “now just a matter of how the government takes action.” And that’s where you come in.
The consultation is also crucially public, with the calling for people to submit their evidence on current pricing practices and continue engaging in the discussion throughout the progress. New Year’s Resolution: let’s curb ticket touts as much as we possibly can.
Georgina Pellant -
23rd November 2021 
