The Government has been accused of ‘sneaking out’ a last minute change to the law, which would make it easier to close hospital wards, by placing it before the House of Lords minutes before England played Poland in Tuesday's crucial World Cup qualifier.
The amendment to the Care Bill, put before the Lords late on Tuesday evening, would enhance the health secretary Jeremy Hunt’s powers to authorise closures and other changes at hospitals in areas where an NHS trust had been placed into administration. It comes in the wake of the Government’s High Court defeat over plans to cut A&E and maternity services at Lewisham Hospital, as part of a reorganisation of NHS services in south London earlier this year.
Labour peer Lord Hunt said that the measure, which will be voted on next Monday, was of great importance and needed to be debated fully, but had been “sneaked out 10 minutes before the start of the England-Poland game”.
Government plans to cut services at Lewisham hospital were deemed unlawful in July, after a judge ruled that the Trust Special Administrator (TSA) brought in to change services at the nearby South London Healthcare Trust did not have the authority to recommend changes at a neighbouring hospital trust.
The amendment would clarify the powers of TSAs to “remove any doubt” that they can make “recommendations that affect other NHS trusts, NHS foundation trusts or other providers where they are necessary for and consequential on the actions recommended for the trust” and also guarantee the health secretary’s power to accept any such recommendations.
Lord Hunt, a former minister and the president of the Royal Society for Public Health said: “The idea that the special administrator can come in and make recommendations which would put the viability of another hospital at risk doesn’t seem to me to be the right way to do it. We know a lot of NHS trusts are in financial trouble… I wouldn’t be surprised if lots of these special administrators have to be appointed in the future.”
Heidi Alexander, MP for Lewisham East, said that the amendment could lead to “the indiscriminate closure of hospital services with very limited opportunity for the public to have their say.”
“The primary consideration when you are reorganising health services should be what is in the best interest of patients and not just a desire to meet the accountant’s bottom line,” Ms Alexander told The Independent. “With this special administration regime, what we have seen in south London is that the clinical case for change is tacked onto the end of the process when it should be the foremost consideration.”
A Department of Health spokesperson said: “This amendment was tabled six days ahead of the debate in the house. At the same time a letter went to peers which explained that the amendment was intended to clarify the existing legislation.
"We need an effective regime for dealing with NHS providers who are unsustainable. It is in everyone's interests — patients, providers and commissioners — that the rules governing this regime are well-defined and understood. Whilst we firmly believe the existing legislation on the TSA is right, we're seeking to make these amendments to put beyond any doubt for the future that [the TSA] has the power to make recommendations affecting other NHS providers.”
The proposed amendment comes as the Government’s health reforms were blamed for jeopardising good patient care, after a merger between two Dorset NHS trusts – deemed in the best interests of patients by hospital officials – was blocked because it was bad for competition
Chief executives of the Royal Bournemouth & Christchurch Hospitals and Poole Hospital foundation trusts said that the decision – which marks the first time the Competition Commission has intervened in NHS restructuring – “put competition ahead of benefits to patients”.
The two trusts proposed merging two years ago, but under the Health and Social Care Act, mergers between foundation trusts must be reviewed by the Office for Fair Trading, which referred the case to the Competition Commission. The Commission ruled yesterday that there was insufficient evidence that the merger’s benefits to patients would outweigh concerns about competition in the healthcare market.