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We Need a More Courageous, Robust Response If We're to Save Our NHS

21/11/2014 09:20 GMT | Updated 20/01/2015 10:59 GMT

Figures released this week show private health firms are on course to win more than £9billion of NHS contracts.

This Friday, I'll vote for a Bill which seeks to challenge the stranglehold of privatisation on our NHS.

That Bill - the National Health Service (Amended Duties and Powers) Bill, from Labour MP, Clive Efford - is a step in the right direction, and is welcome as such. The situation is grave and the Efford Bill gets the ball rolling. It stops short of what it needs to be (more of which soon) but it does step up the debate about the privatisation of our NHS.

And not a moment too soon. The NHS is on the edge of being hollowed out into little more than a logo.

There is good in Efford's Bill. The Health and Social Care Act 2012 (HSCA) fundamentally undermined healthcare in this country. It's been a costly, unnecessary and underhand waste of money, implemented by those who don't believe in a public health service but who do want to shrink successful public services to allow profiteers access to the £110billion a year NHS budget.

This Bill would repeal the 'competition' sections of the pernicious HSCA 2012 - and I welcome its attempt to reduce procurement and tendering procedures. It also looks like it would revoke regulations that force commissioners to advertise new NHS contracts to the private sector (unless the services are only capable of being provided by a single provider).

The 2012 Act united an extraordinarily broad coalition of opposition to its core purpose (being to permanently hollow out public provision in the NHS and instead create a cash cow for the corporate health sector) including the BMA, Royal Colleges, 38 Degrees - I worked closely with Liberal Democrat rebels and the Opposition on key amendments to the Bill.

Now, I urge that same coalition of people who love and value our NHS as a public service to put aside party politics and join together to protect the NHS for generations to come.

Our NHS is in danger. It'll take vision and swift, collective action to rescue it from the privateers.

And it'll take a Bill that goes further than Efford's. Friday's Bill is a good start - but it wouldn't re-establish the Secretary of State's duty to provide the NHS (despite the long title of the Bill saying that it would...)

Instead, it introduces a duty to 'commission' services. My fear is this leaves the door open for privateers to bag profits for their shareholders on the back of NHS spending.

This could actually extend the market principles that have been increasingly applied to the NHS over the last 25 years.

Scrapping the internal market was something that Tony Blair promised to do in 1997. By his second term he'd performed a total about face and extended that market structure. Private Finance became the norm - anyone who spoke out was branded wildly left wing.

New Labour's record and the privatisation they introduced cannot be ignored, because it laid the foundation for the Coalition's attack on the NHS. If we leave the building blocks the privateers set down in the 2000s, we leave the NHS vulnerable to attack in the future, and it's far too precious for that.

As it stands, the Efford Bill needs several improvements. To take three:

The Bill appears to defer unnecessarily to EU competition law. Competition should never apply. Yet this is left unclear in the Bill.

The Bill does not reverse the 2012 Act's prospective abolition of NHS trusts, and their transformation into NHS foundation trusts or take over by private companies; The 2012 Act requires all NHS trusts to become NHS foundation trusts, and if they cannot they will be merged, closed or taken over by private companies. As the Bill stands, this would appear to remain the position.

The Bill does not appear to exempt the whole of the NHS from Transatlantic Trade and Investment Partnership Treaty (TTIP). Sounds great - especially the heading: 'NHS exemptions from proposed [TTIP].' The reality is less assured. Respected health lawyers are concerned about lack of clarity and potential loopholes - it needs to be watertight.

Time is running out for our NHS - but it's for this very reason that the Bill to save it must be both rigorous and comprehensive.

We need a restoration and a rescue package for our health service. Which is why I hope Friday's debate will lead those who love our NHS to take a serious look at the NHS Reinstatement Bill, by Prof Allyson Pollock, and health lawyer Peter Roderick.

The NHS Reinstatement Bill does what it says on the tin. This is the Bill for a truly publicly-provided healthcare service. I hope the shadow secretary of state for health will follow its logic. Our principles for reform should not be shaped by who privatised the NHS but by how it was privatised and where the dangers still lie.

I support Clive Efford's Bill as a step forward. But we need a more courageous, robust response if we're to save our NHS. To that end, I urge all those who want to keep our NHS public to back the NHS Reinstatement Bill.