11.03.14
MPs to vote on ‘hospital closure’ clause
MPs will today vote on the divisive Clause 119 of the Care Bill, which gives trust special administrators (TSAs) the power to close down any hospital or A&E departmentwith 40 days' notice.
The controversial ‘hospital closure’ clause was inserted into the Care Bill after the courts twice ruled that health secretary Jeremy Hunt’s attempts to close Lewisham Hospital’s accident and emergency and maternity wards were illegal.
Theprovisionenables the secretary of state to mandate service change across a whole health economy, not just within trusts subject to the failure regime. But perhaps the most significant amendment is that aTSA closure proposal will not require public consultation or universal commissioner support.
There has been cross-party opposition to Clause 119, with former Lib Dem health minister Paul Burstow MP among those fighting it. He is seeking to amend the Care Bill to remove the closure provisions, and says about 20 Coalition MPs will either support him or abstain.
He said: “Support for my amendment has been growing. It feels to me that there's a growing disquiet on the Conservative side of the coalition about these plans, plus there are Liberal Democrat MPs who share the concern.”
Labour made a direct appeal to MPs to join the campaign against the amendment.
Shadow health secretaryAndy Burnham MPsaid: “This government used to say it wanted to put patients and doctors in charge of the local NHS. Now Jeremy Hunt wants to ride roughshod over local communities and have carte blanche to break up the NHS without anyone else having a say.
“Labour is clear: changes to hospitals should be driven by clinical, not financial, reasons with local people involved every step of the way. That is why we believe these plans are dangerous and wrong.”
Hunt, however, insists the changes are essential to secure the long-term future of the NHS.
King’s Fund policy manager Becca Ashton, writing about Clause 119 last year, said there are many “unanswered questions”: “Could service change be forced on unwilling providers and, if so, what does that mean for the autonomy of foundation trust boards? What would happen if local commissioners do not choose to purchase the reorganised services? Could the competition authorities be the only check and balance left in the system? What happens if the competition authorities block proposals supported by the TSA and the secretary of state?
“Any discussion of failure and the role of the special administrator brings to the fore the dilemmas all system leaders face in this area: implementing legislation that unblocks much-needed service developments but could lose support from commissioners, clinicians and the public, potentially undermining efforts to create a less centrally-controlled health system.
“While it is clear that the failure regime is intended to be enacted only in extreme circumstances and where other attempts at reconfiguration have failed, the tension between central direction on the one hand and a competition-led approach on the other is very hard to reconcile.”
Below is a selection of tweets about Clause 119:
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