I’ve been trying to follow the blow-by-blow reactions to the changes the government has made to the Health & Social Care Bill following yesterday’s publication of the NHS Future Forum’s report.
There is a full transcript of today’s speech by David Cameron speech at Guy’s Hospital here.
The Dept of Health summarises the key revisions to the Bill here.
GP Online says that “the government has watered down its plans to increase competition in the NHS, and will make health regulator Monitor’s core duty to protect and promote patients’ interests’.
A Guardian editorial here says that concessions to the ‘listening exercise’ are a messy compromise that have more to do with placating both wings of the coalition than they do finding viable, coherent solutions to some of the problems facing the NHS.
To my mind, a partial, messy U-turn is a (probably temporary) victory for the NHS and its founding principles. I have always felt that as far as social enterprise is concerned, it has to have a bigger set of values than simply finding business opportunities wherever these may exist, and in whatever circumstances — even if these include the dismantling of the NHS. It isn’t social enterprise’s job to help the government introduce ‘social capitalism’ (or whatever you may wish to call it) into the health service.
But not everyone thinks this way, I know. My old friend Chris Newis, who many of you will know, a stalwart of co-operation and the social enterprise sector for over three decades, takes a quite different line. Just an hour or two back he emailed:
Changes to the Health and Social Care Bill are not good news for social enterprise. When the Health and Social Care Bill was announced Secretary Andrew Lansley proclaimed that it was the Coalition’s intention to create the biggest social enterprise sector in the world in the National Health Service. This was to be achieved by the new regulator – Monitor having a role in promoting competition.
Today’s announcement that the Coalition has accepted the recommendations of the Future Forum on the Health and Social Care Bill puts paid to Lansley’s social enterprise aspirations and spells disaster for the continued growth of the social enterprise sector in the NHS. In order to continue to grow as part of a mixed economy of health care provision, established by the previous Labour Government, social enterprise needed a commitment to the widening of the market within the NHS that was begun by the last government.
Today’s announcement on the Department of Health website, states clearly that is not to be the case. While “Any Qualified Provider” will continue it will be restricted to community services. The strengthening of a commitment to integrated services, will also limit the number of providers and keep more NHS activities within the existing public sector again restricting the potential for social enterprises to “spin out” of the NHS.
What do you think?