We asked Jenny Shepherd of 'Calderdale & Kirklees 999 Call of the NHS' to tell us about the 'Dont Blow It' campaign aimed at putting pressure on MPs in marginal seats to vote again the Bill. Here Jenny outlines what is being done and the thinking from '999' and others behind this action.

NHS activists have embroidered handkerchiefs for the 60+ most marginal English MPs with the message:

“Don’t Blow It! Kill the Health and Care Bill before it kills us”

We Own It and campaign groups in the marginal constituencies will be delivering the handkerchiefs to the MPs, urging them to vote down the much-criticised Bill that will accelerate the privatisation and destruction of the NHS.

The aim is to show MPs who have the most to lose - their seats in the House of Commons - that the public won’t stand for dismantling the NHS.

Mary Whitby, Don’t Blow It! campaigner in Lancashire said,

“If our elected politicians don’t oppose US-style Integrated Care Systems, they will pay heavily at the ballot box while ICS managers get away with their big bonuses and knighthoods.”

Why we are holding the Don’t Blow It! campaign

We believe the Bill must be stopped as it is not fit for purpose and NHS and social care legislation must be deferred until a Bill can be drafted that will enable:

• World class health care for all
• A national system, adequately funded and free at the point of need
• Providing comprehensive treatments based on the patient’s best interest, decided together with clinicians not on the basis of financial calculations
• With national NHS staff pay and conditions and professions regulated independently of government politics.

We do not believe the Bill can be amended in a way that will enable any of the above. This is for the following reasons:

The Bill is bad for patients

The Bill reduces the government’s obligations to secure NHS care for us all in clause 15, 16 and 18.

By reducing the government’s obligations to secure NHS care for us all, the Bill:

• Could result in whole areas without hospital medical services, opthalmic services or the provision of emergency services for everyone present in the commissioner’s area.
• Would entitle providers of services to have: “discretions… in relation to anything to be provided” by them.

The Bill also risks restricting patients’ access to care on the basis of actuarial considerations, as a consequence of the tight financial controls it hands to Integrated Care Boards (Health and Care Bill Part 1, section 23,3), combined with risk/reward share contracting that makes providers carry the burden of any “overspending”.

In this way, the Bill will force people to go without the treatment they need, or to pay for healthcare if they can afford it more than they already do.

The Bill is bad for NHS staff

The Bill would worsen the current NHS front line staff shortage - currently amounting to 40,000 full-time equivalent nurses and 49,000 full-time equivalent doctors and doctors in training in England across primary and secondary care.

This is because it would make the professions less attractive by undermining already poor working conditions and pay – it would:

• Threaten national agreements on wages, terms and conditions of employment by putting pay agreements under the control of Integrated Care Systems.
• Allow for the introduction of un-regulated workers such as physician and nursing associates, and require that health care professionals are regulated in a 'cost efficient manner', as outlined in the White Paper on page 63 and 64. Regulatory bodies currently operate autonomously from the Government.
• Introduce flexible staff redeployment across NHS organisations, based on “learning” from redeployment of nurses and doctors during the Covid-19 pandemic. This means staff working outside their trained competences and having to travel to different places to work for other providers

In this way, the Bill seems set to perpetuate the moral distress and moral injury to NHS staff that occurred during the pandemic, with risks to life and mental and moral wellbeing.

A Bill for big business

Huge global companies are driving the formation of the 42 ‘shadow’ Integrated Care Systems. They are remaking the NHS in the image of their own systems, developed for the US ‘managed’ health care market which cuts costs by restricting patients’ access to care and introducing clinical staff without professional regulation and competencies such as physician and nursing associates.

These companies will be entrenched in the NHS by the Health and Care Bill’s imposition of a “duty to integrate” (Clause 19), and its creation of a power to create a separate procurement regime...,, removing the procurement of health care services from the scope of the Public Contracts Regulations 2015 and repealing Section 75 of the 2012 Act and the National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013. (Health and Care Bill Explanatory Notes, 114, p 29),

There is nothing in the Bill to stop these and other companies from being members of the new statutory Integrated Care Boards, which will:

• Decide which health services are provided in a local area (and which are not).
• Be allowed to award contracts for clinical care to private healthcare providers without considering other bids - enabling further privatisation and cronyism.

This not only puts taxpayers’ money in the pockets of shareholders - it gives private companies a say in how public money is spent in the future.

The spin by both government and Labour Party MPs such as Karen Smyth - a member of the Public Bill Committee - that the Bill represents the end of the era of marketisation,  could not be further from the truth.

The Bill will do nothing to solve the NHS’s problems

A recent systematic analysis of evidence concluded:

“In theory, collaboration between local health care and non-health care organisations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers.”

Getting the government to withdraw the Bill would make Parliamentary history

Governments have been defeated on amendments and motions but not on whole Bills, we think.

But the Don’t Blow It! action is just one part of a campaign across the country to stop the Bill – dubbed the NHS Corporate Takeover Bill by national campaign group We Own It.

To find out how to take part in the action, email Calderdale and Kirklees 999 Call for the NHS at [email protected]

Find out more from Keep Our NHS Public

We held a great online rally Protect the NHS - Scrap the Health and Care Bill on Wednesday 8 September from 7-9pm to discuss the threat the Bill poses and how we can campaign against it.

Featuring Julie Hesmondhalgh, actor, Michael Rosen, writer, Jonathan Ashworth MP Shadow Secretary of State for Health and many of our own campaigners.