Why the Health and Social Care Bill has to be amended or abandoned if we are to have an NHS

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Allyson Pollock - one of my heroes - wrote this in the Guardian today. Please share it widely, which is why I quote at length:

Put simply, the legal effect of the [Health and Social Care Bill] is to abolish the statutory basis of a national health service by repealing duties to provide a comprehensive and universal service. The change is effected by creating clinical commissioning groups (CCGs) with an obligation to cover fewer services and responsibility for fewer patients and residents than primary care trusts (PCTs). Whereas PCTs act on behalf of the secretary of state, CCGs will exercise functions in place of him or her but without a clear primary legislative framework. The bottom line is that commissioners and providers in the new market will have freedom to select patients and services on financial grounds and to redefine eligibility for NHS care and in so doing introduce charges for care.

The blurring of boundaries and responsibilities for funding and provision will make it almost impossible for parliament to hold health bodies accountable for the various elements of their expenditure or for the secretary of state to carry out his or her duty to promote a comprehensive health service throughout England.

The key features of the bill are therefore the move from comprehensive, universal, geographical duties and the assignment of extraordinary discretion to CCGs and the NHS commissioning board. These elements are laid down largely in part one of the bill. It is vital that amendments focus in the first instance on clause 1, which deals with the existing duties of the secretary of state, and clause 10, which sets out the new powers of CCGs.

Reports of drastic cuts to NHS frontline services lie behind the extreme urgency with which the government is pushing its changes. Cuts on the scale envisaged are only possible if the duties laid on government by parliament are abolished. So it is the bill or the NHS; the people will rely on the crossbenchers to decide their fate.

We have to hope the argument against the Bill prevails. Lives, quite literally, depend on it doing so.