The highly controversial Health and Social Care Bill returned to the Commons last week. Its progress was previously paused and promises made to listen to critics and reflect on their concerns.
Some changes were made but actually make the legislation more complex, costly and confused.
We will see millions squandered on new bureaucracy instead of worthwhile spending on patients' needs.
My grave fear is that this legislation will break up the NHS as a national public service and treat health care as if it were merely any other market with delivery by autonomous and largely unaccountable bodies.
The new regulator will enforce competition law on the NHS for the first time including the power to fine hospitals a up to a tenth of their turnover for having the temerity to work collaboratively with others.
There will be no limit on the number of private patients who can pay to be treated in our NHS hospitals but this could be at the expense of NHS patients who would have to wait longer.
This means that the planning and co-operation that makes the NHS one of the best health systems in the world will be harder and potentially illegal. Competition lawyers will have a field day.
More fundamentally, ministers are no longer mandated to provide a comprehensive service. The Bill passes the buck to hundreds of local commissioning groups and stops the Minister directing them as to the services that they must provide for patients.
The Government won't be accountable for what health services are provided and cannot guarantee patients a universal service.
This Bill takes the "national" out of the National Health Service.
These are disruptive and expensive and unwelcome changes when we are struggling to cope with the impact of cuts and extra VAT.
Increasing longevity and medical breakthroughs which increase survival rates are great news for those involved but also increase NHS costs over time.
Keeping up to date and searching for improvement is always necessary in such a large service. But it is also true that the health service has coped well and commands popular support.
My guess is that this week's Bill will haunt this government until the next election and the coalition parties beyond that.
Newcastle Chronicle and Journal
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