12.03.14
MPs vote in favour of controversial Clause 119
Yesterday MPs voted through a controversial measure that will give Trust Special Administrators (TSAs) the power to close hospitals and reconfigure local health services, even if they themselves are not struggling financially.
Tucked into the Care Bill, Clause 119, which has become commonly known as the ‘hospital closure clause’, gives administrators the power to downgrade hospitals and units, giving local patients and clinicians little chance to object. Supporters of the Clause say that any decision made about hospital services will also have a wider impact on its local healthcare economy, which is why the TSAs have to be able to make recommendations that do not just focus on a single failing provider in isolation.
The controversial 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 in 2013 were illegal.
However, despite strong opposition, a total of 297 MPs voted in favour of Clause 119, while 239 voted against it, according to the BBC’s count.
A Department of Health spokesperson told NHE: “Changes to the special administrator regime will ensure that patients get safe care, and these powers have only ever been used in extreme cases twice since 2009.”
They added that “it is a process of last resort, when a hospital trust faces very serious financial or quality risks”.
Prior to the vote on the Care Bill, former Lib Dem care minister Paul BurstowMP had drafted an amendment to give local doctors who commission services from a particular hospital– not directly involved in the other's problems– the right to veto any such plans for an administrator to interfere in its running.
But during yesterday’s Parliamentary debate,health minister Dr Dan Poulter MP said that the amendment, known as ‘Clause 9’, could not be accepted as it was too “cumbersome”.
However, he did make two announcements:
• New guidance will be issued to make it clear that, when a trust special administrator is considering closing a service, commissioners from other trusts will be consulted and they will take into account the need to protect other services.
• Burstow will be invited to chair a committee of MPs and peers to draft this guidance.
Following this, Burstow did not press his amendment to a vote and said his concerns were now “satisfied”.
Speaking to campaigners from 38 Degrees, which has been campaigning strongly against Clause 119, Burstow said: “For me the starting point must be that decisions about the future of local health services are grounded in clinical evidence, supported by local clinicians and drawn up with the active involvement of local people. In the last few days with the support of emails from 38 Degree members to MPs and the 159,000 signatures we have got the Government to make some important concessions. The amendment played a vital part in getting ministers’ attention.
“Today ministers gave Parliament the assurance that everything possible will be done to help any potentially failing hospital to sort out their difficulties so that a TSA is only ever used in rare and extreme circumstances. Following my lobbying ministers have amended the Bill to strengthen public and patient involvement by the inclusion of local Healthwatch. In addition local councils are being added for the first time too. In the Lewisham case the local council played a vital role in standing up for local people.
“Also as a result of today TSAs will have to consult with NHS Trusts and their staff and with commissioners (CCGs) of any affected NHS organisations. And as a result of the amendment ministers have conceded that equal weight must be given to views of each involved Trust, staff and commissioners. Finally Ministers confirmed in response to my amendment that any TSA plan must have the agreement of ALL relevant commissioners.”
Butshadow health secretary Andy Burnhamtold MPs that Clause 119 was dangerous and wrong.He said: “It creates an entirely new route for hospital reconfiguration – top-down, finance-led.
“It subverts the established process in the NHS which requires that any changes to hospitals should first and foremost be about saving lives, rather than saving money, and it puts management consultants, not medical consultants or GPs, in the driving seat.”
Health secretary Jeremy Hunt insisted the changes are essential to secure the long-term future of the NHS.
A Department of Health spokesperson added: “When a Trust goes into administration, it is necessary to give the administrator enough power to take the difficult decisions necessary to ensure patients get safe care, including looking at the wider health system locally and our proposals extend the requirement to consult and engage with local people and local doctors.”
The Bill will receive a third reading and a further consideration of amendments before receiving royal assent and passing into law.
(Image shows campaigners against the proposed downgrading of services at Lewisham Hospital last year. Stefan Rousseau/PA Wire)
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