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Below is the text of a motion on the NHS reforms that wasn’t accepted for debate by Conference Committee, including two short update paragraphs. Dr. Charles West is appealing this rejection, if you’d like to support this appeal please click here to sign up.

Conference Motion on Heath

Conference…
A) notes

1) the long-standing support of Liberal Democrats for the basic principles underpinning the National Health services: A high quality, accountable, responsive, accessible, comprehensive service, free at the point of use, funded by general taxation, with resources allocated fairly on the basis of need.
2) the decision of this conference in March 2011, to reassert our support for the implementation of the health policies in the Coalition Programme and to reject certain policies that were not in the Coalition Programme.

B) applauds the success of the Liberal Democrats in Government and in Parliament in obtaining amendments to the legislation and policy, including those which:-

1) increase transparency and accountability of Commissioning Consortia and ensuring they are responsible for the commissioning services for everyone living or visiting that area
2) uphold and promote the NHS constitution
3) rule out competition based on price as first suggested by the last Labour Government
4) modify Monitor’s role such that it is no longer an economic regulator charged with promoting competition as an end in itself,
5) recognises the importance of integrating health services and integrating health with social care in the interests of delivering high quality care.
6) the promise of fair financial arrangements to reimburse providers who treat patients with the greatest needs to tackle cherry-picking of patients by new providers;
7) remove the obligation on commissioning consortia to take responsibility for commissioning before they are ready and able.

C) recognises that the Government is itself no longer the universal provider of health services, but that democratic accountability of NHS services requires that the Secretary of State should retain the ultimate legal responsibility for securing the provision of NHS healthcare for the people of England

D) recognises that determining how to spend tax-payers’ money on NHS services is a public function, which must be carried out with full transparency, with the minimum of perceived or actual conflicts of interests; and reiterates our call for work which directly underpins commissioning decisions to be carried out using the skills and experience of NHS staff, and not be permitted to be outsourced to private companies.

E) Believes that promoting informed patient choice is desirable but, in the interests of equity, calls for:-

1) any legislative or mandated requirement on commissioners, the NHS CB or the Secretary of State, to enhance choice and competition should be a lower priority than their duty to increase quality and safety, improve fair access to services and reduce health inequalities.
2) patients, if utilising personal health budgets, to be prevented from spending tax-payers money on topping up privately-funded provision or on non-cost-effective treatments

F) endorses the proposition in the Coalition programme that public sector, voluntary sector providers and independent providers should generally be treated equally when services are commissioned or when providers are approved, subject to:-

1) there being a duty on the NHS CB, Consortia, Monitor and on the Care Quality Commission (CQC) to carry out their functions in a way that avoids the risk of a transfer of such income or case-load as to undermine the ability of existing providers to provide emergency, complex case and intensive care services and to provide education, training and research and
2) that Monitor’s duty to prevent anti-competitive behaviour which is against the interests of patients, is matched by a duty to prevent anti-collaborative behaviour for the same purpose.

X) re-affirms its long-standing support for more local democracy in the NHS and calls for

1. Health and Well-being Boards (HWBs) to have a majority of elected members
2. local authorities exercising their overview and scrutiny function and HWBs to have the power of referral to the Secretary of State
3. commissioning groups to be fully co-terminous with social services local authorities, except where HWBs and local authorities agree otherwise
4. Directors of Public Health to remain independent sources of expert advice

Y) cherishes the fundamental values of the NHS and demands that
1. Commissioning groups are funded solely on the basis of the health needs of the population and the power to pay financial incentives to practitioners as a means of influencing their referral behaviour, is removed
2. the cap on Private patient income by NHS Foundation trusts is retained
3. the facility for transferring NHS assets, including land, to third party providers is removed

G) calls on Liberal Democrat parliamentarians to ensure that the current health reforms do not go beyond the coalition agreement in these areas

Dr. Charles West is submitting an Emergency Motion on the NHS reforms. If you would like to support this motion please click here to sign up.

Reforming the NHS

Conference notes that the March 2011 Conference clearly rejected several aspects of the Health and Social Care Bill (“the Bill”), which breached the agreed Coalition Programme.

Conference applauds Nick Clegg and our ministerial team on achieving changes to the Bill reflecting some of those concerns.

Conference however further notes
a) that since the beginning of July the Bill has been amended in the Public Bill Committee without fully addressing our concerns.
b) that the Government published further amendments on 2nd September for the report stage of the Bill on the 6th and 7th September 2011 without address any of the outstanding concerns.
c) the amended Bill still contains significant proposals for the NHS which go well beyond the Coalition Programme and have widely criticised by health professionals, academics, managers, and the wider public over the Summer.
d) after the re-examination of the Bill in committee and after Parliament had gone into recess the Health Secretary issued instructions to PCTs obliging them to identify three services to be put out to contract in an exercise that could see an extra £1bn of NHS money being paid to private providers.

Conference is concerned that:
I. the underlying Conservative agenda is the fragmentation and privatisation of the NHS, with the Secretary of State and the NHS no longer delivering healthcare but simply buying it in the ‘market’.
II. the promotion of “choice” is being used by the Conservatives as a smokescreen for the promotion of competition at the expense of co-operation and integration.
III. the NHS in England is being floated off into independent buyers and providers of care divorced from the state and from political accountability, and that £80 billion of tax-payers money is to be spent with little or no direct political accountability at local or national level.

Conference believes:
A. that a competitive market is not an appropriate model for delivering healthcare in the UK, nor one that the Liberal Democrats can help to bring nearer.
B. that Liberal Democrat MPs and peers should not be whipped to support Conservative policies that go beyond the coalition agreement and which have been rejected by our conference.

Conference therefore for calls for the bill to be amended by:
1. the removal of all references to promoting competition whether directly or indirectly.
2. any duty to promote choice being made subsidiary to duties to promote fair access, equality of outcomes, and integrated services.
3. the removal of the facility for transferring NHS assets, including land, to third party providers.
4. retaining the cap on Private patient income by NHS Foundation trusts.
5. the restoration of the duty of the Secretary of State to provide or secure the provision of, healthcare services, and the reinstatement of the power of the Secretary of State to delegate his functions to NHS commissioners and to direct them as necessary.
6. the retention of the ability of the local authority overview and scrutiny function to refer significant services changes to the Secretary of State for adjudication.
7. providing that Health and Well-being Boards (HWBs) have a majority of elected members and are able refer unresolved disputes with local commissioners to the Secretary of State rather than to a national qango.
8. the explicit prohibition of the wholesale outsourcing of commissioning work to private companies.
9. guaranteeing that commissioning groups are fully co-terminous with social services local authorities, except where HWBs and local authorities agree otherwise, and are funded solely on the basis of the health needs of the population.
10.the removal of the power to pay financial incentives to practitioners as a means of influencing their referral behaviour.
11.rejection of any personal health budget scheme which allow users to spend NHS funds on private health insurance or as a top up towards private health care or to buy services or treatments judged too ineffective or inefficient for the NHS to buy.
12.the inclusion of a duty on all NHS bodies, when arranging with non-NHS bodies to provide services, to avoid any risk of essential NHS services (including teaching and research) being destabilised in an unplanned way through loss of income or case-load,
and
13.ensuring Directors of Public Health remain independent sources of expert advice.

and further calls for the active support of these objectives, as party policy, by Liberal Democrat Parliamentarians and, in the absence of all of these changes being made, calls for Liberal Democrat Parliamentarians to reject the Health and Social Care Bill in its entirety.