Friday, 7 October 2011

Democratic breakdown

Polly Toynbee is reporting that the NHS "health and social care bill" is being implemented before the House of Lords has scrutinise this piece of legislation.

The CONDEM government never sought a mandate for a top down reorganisation of the National Health Service, neither the Conservative nor the Liberal Democrats placed this proposal in their 2010 manifesto.

The House of Lords should be constitutionally affronted that this reorganisation is already imposed on the NHS without waiting for their consent. No one can remember a similar case of pre-legislative implementation, as if parliament were irrelevant.

Polly Toynbee is reporting the NHS is;

Without waiting for the legislation to be passed into an Act and seeking Royal Approval: 300 clinical commissioning groups are taking over, nominally run by GPs. Private sector involvement is already compulsory: by this month every commissioner must find at least three outside providers for diagnostic tests, audiology, primary care psychological therapies, treatment for back pain, feet and other services.

Department of Health website instructions say: "Commissioners cannot refuse to accept providers once they have qualified." That's what "any qualified provider means" and it's happening now – forget the law. McKinsey and other consultants are already being paid millions by commissioners to work out the payment system.

How do these new providers become "qualified"? They must register with the Care Quality Commission, the regulator whose severe stress was revealed over the Winterbourne View scandal. Created from merging three bodies, plus possibly the human fertilisation authority, this bill gives it the new HealthWatch too. Can they cope? CQC has 30% less cash than the bodies it replaced. Last year it cut inspections by 70%. It has just 900 inspectors to cover 18,000 care homes, 8,000 GP practices, 400 NHS hospital trusts, 9,000 dental practices and now every new "qualified" entrant. Will the Lords really think proliferating providers will be sufficiently inspected?

Why should the NHS be opened up to EU competition law? Other than private companies to cherry pick the NHS and Social Services.

I have tasted the new NHS, I had chronic pain in my ankle and needed to see a Podiatrist, my GP offered me a piece of paper with a private practice on it, as a footnote my treatment cost about £400 to put the ankle right, so future commissioning services will not be done in your GP surgery: the 300 CCGs will be cut back to many fewer, commissioning from afar and often outsourced to private companies.

The democratic deficit doesn't stop at the government, parliament with lose control and if the health and social care bill is enacted, it will be illegal for parliament to intervene in this newly formed Quango.

Power will pass to the Conservative friends that fund that Party, insurance groups and private health interests.

Where are the Liberal Democrats, Tessa Munt (my) MP Lib Dems for Wells has loyally supported the coalition government on this legislation (Vote Lib Dem get Tory), they have lost all credibility, they have lost their identity and hopefully Lib Dems will be wiped out after the next election.

The NHS has high satisfaction figures, it is efficient and effective at delivering health provision, but the cuts the coalition government is imposing £20 billion, we are seeing waiting lists growing.

The tragedy is the end of the NHS is near and the people are oblivious to the fact, like the banker with the five ace hand (or a shed load of cheap credit easing), the people cheated out of one of the greatest institutions.

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