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Mar 11th, 2014

Hospital Closure Clause: what do you think?

By becky

Late this afternoon, MPs debated the Hospital Closure Clause. Since then, the office team has been trying to work out what to make of how it went. It’s quite complicated, and there’s still quite a lot of analysis to be done.

Here’s some questions 38 Degrees members will need to consider together over the next few days:

– how far has the government moved to meet our concerns?

– the government says the changes needed can be written into guidance which is prepared after the law is passed. Is this true, or do we need to amend the law further when it returns to the House of Lords?

– what other things could we be doing, together, to keep our local hospitals safe?

Please comment below with your thoughts.

Here’s what Paul Burstow MP thinks:

I want to thank 38 Degrees members in my constituency and across the country for raising concerns about the changes the Government was proposing to the way in which a hospital in serious financial or clinical trouble is handled in the NHS.  Trust special administration (TSA) as it is known was introduced by Labour in 2009.  It is a blunt process that should only ever be used in exceptional circumstances.

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.

When it came to pushing the amendment to the vote I had to make a fine judgement.  Having secured important changes and commitments from the Government I took the view that pushing the amendment to a vote ran the risk of defeat and sacrificing what the Government had offered.

That is not the end of the matter.  A cross party committee of MPs and Peers will be set up to agree the guidance to TSAs.  I will be chairing that Committee and I am keen to engage with 38 Degree members as we draw up the rules to make sure the views of local clinicians and local people are heard.

And here’s a response from Jamie Reed MP, Shadow Health Minister:

I read Paul Burstow’s blog to 38 degrees members and to give him credit he was right about one thing – the amendment certainly got Ministers’ attention. So much so I had Tory MPs coming up to me last night saying that George Osborne was dragged in at the last minute to heed off any potential rebellion in the Commons.

Looking at the voting figures, the real tragedy is that if Paul had pushed our amendment to a vote, and brought with him the Lib-Dems, we could have won that vote last night. Instead only one Lib-Dem ended up voting for Paul Burstow’s amendment. And it wasn’t Paul Burstow.

The truth is no meaningful improvements to the hospital closure clause have been secured and it would be delusional to believe that they had.

But let’s have a look at the “important concessions” the Lib-Dems claim they won.

The first concession is a new job for Paul chairing a committee of MPs and Lords which will look at the guidance on how the legislation will be used in future. I’m not holding my breath.

The second concession is that Healthwatch will have a say in any decisions made. That’s the same Healthwatch who under the Health and Social Care Act is barred from criticising Government policy. And that’s the same Healthwatch who has just had its funding cut by £10m.

The final concession is that the Trust Special Administrator will now have to ‘consult’ with NHS staff affected by the changes, but crucially they will be under no obligation to take their advice, and, unbelievably, they will not be required to consult with local people.

I’m afraid Paul has sold out thousands of people who signed the 38 Degrees petition for some pretty meaningless public relations designed to let Jeremy Hunt get his way and save the face of the Lib-Dems.

We knew this was always likely to be the case.

The truth is that – from the widely hated Heath & Social Care Act onwards – the Lib-Dems have enabled the Conservative Party’s vandalism of the NHS. 38 Degrees members came under attack from Conservative MPs during yesterday’s debate – and not for the first time. Let’s not forget it was your donations that paid for the legal advice that drafted the amendment that Paul refused to push to a vote.

Instead it was left to Labour to ensure that the voices of the 159,000 petition signatories – and millions more in the country at large – were heard in Parliament.

Reading Paul’s justification for his actions, I was reminded of Ricky Gervais’ David Brent character breaking the news of redundancies to his staff after promising them there would be none: “The bad news is there will be redundancies. The good news is, I’ve been promoted…”

But it’s not all bad news. It turns out that the job offered to Paul in the chamber of the House of Commons in return for not moving the amendment is not remunerated. That’s bad luck – at least Judas was paid.

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