Section 119 of the Care Bill currently going through Parliament is a lot more insidious than has been realised. It allows trust special administrators (TSAs) to close down any hospital or A&E with just 40 days’ notice. The doctors and consultants are rightly up in arms about it because, contrary to all the assurances given when the Lansley bill was forced through the Commons in 2012, the NHS will be able to be reconfigured without any agreement from the new GP commissioners who are supposed to be running the service, and without any proper consultation with patients and the public. It will be seen as Hunt’s revenge after he was thwarted, when the South London healthcare trust went bust partly because of an unaffordable PFI, from purloining the adjacent Lewisham Hospital A&E and maternity services to fill the black hole. The latter services were in good shape both financially and clinically, but in Hunt’s eyes they were useful prey to stave off a financial collapse in the adjoining locality. The Court of Appeal however threw out the plan, so Hunt promptly brought the power back under new legislation.
But the main aim was not to override the new Clinical Commissioning Groups (CCGs). It was rather to stop a ripple of closures cascading across the NHS. As the £20bn cuts over the current 5 year period, an unprecedented cumulative 4% a year, dig ever deeper into the muscle of the NHS, half of the acute trusts under the Trust Development Authority are now in serious financial trouble. Some 39 of the 100 foundation trusts are similarly at risk. Labour has published a list of 32 trusts which are now forecasting the worst deficits. It is clear that if this new TSA power were not in place, allowing the seizing without redress of financially sound services nearby, the NHS could well be crippled by a wave of bankruptcies within years, if not months. Hunt has claimed in the House that the new power is in the wider interests of patients; in reality it is purely in his interest to try to stave off imminent collapse.
The ruthlessness of the Tories in appropriating the NHS to their ideology is now being matched by their readiness to drain it of resources in order to finance budget tit-bits to assuage Tory back-benchers disgruntled by other government initiatives. It is really shocking that Osborne is planning to block the expected 1% in NHS staff pay in order to fund road and other infrastructure projects to quieten Tory opposition to HS2. If this leads to a strike, Labour must be outspoken in denouncing Tory callousness for the provocation causing it.