Shadow Health Secretary Jonathan Ashworth broke with convention last week by challenging the Queen’s Speech: he tabled an amendment regretting that it did not commit to repeal the Health and Social Care Act.

This was evidently aimed at puncturing the Johnson government’s efforts to portray themselves as the most trusted party of the NHS: but it was also a timely reminder that until it is repealed the Act remains the legal basis of the NHS.

Attempts by NHS England to get around the Act’s limitations have led to the establishment of an increasing proliferation of undemocratic and unaccountable organisations with no legal powers or legitimate status, notably Sustainability and Transformation Partnerships and “Integrated Care Systems”.

But there is little point in merely tinkering with details: the Act itself, the regulations attached to it, and the legislation it amended in the 2006 Act to create a competitive market in health care, all stand in the way of progress.

The repeal is needed to:

  • reinstate and strengthen the responsibility of the Secretary of State to provide a comprehensive and universal health care system, 
  • end the focus on competition and the requirement on commissioning bodies to put services out to competitive tender, 
  • begin to unravel the contracts which have opened up mental health, community health, primary care and other clinical services as well as support services to private providers, 
  • and legislate to exclude the NHS and all its services from the provisions of the European Union’s Public Procurement Directive and from the Public Contract Regulations 2015.

Only by legislating in this way to reverse the privatisation process of the last 20 years and reintegrate the NHS as a public service can we protect it from the impact of future trade deals with the US and other countries, and ensure patient data is used only for the improvement of health services and not sold off or exploited for commercial gain.

After a delay while Johnson attempted to steamroller his 100-page Brexit bill through in a breakneck three days, Ashworth’s challenge was debated on October 23, but the amendment was defeated – with the Lib Dems abstaining to give ministers an easy ride.

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