Tuesday 23 October 2018

Health & Social Care legislation, an Act of cruelty

Your NHS - they're taking it all away... 

The 2012 Health & Social Care act removed the duty for the secretary of state to 'provide' health services to citizens of England. This was replaced with a duty only to 'promote'.

The provision was handed down to newly formed Clinical Commissioning Groups (CCGs) in April 2013. These CCGs are now rationing and banning certain medicines and procedures, some say readying to place them on a health insurance list for people to pay for when NHS reforms take hold in late 2019/20. 

Legal basis for CCGs arranging fewer government funded health services

Under the H&SC act, CCGs are allowed to arrange fewer statutory services than provided previously by their predecessors Primary Care Trusts PCTs.

Previously, the “functions regulations,” were that PCTs must provide or secure the following services on behalf of everyone in a specified geographical area:

  • Accident and emergency services and ambulance services
  • Services provided at walk-in centres
  • Facilities and services for testing for, and preventing the spread of, genitourinary infections and diseases and for diseases
  • Medical inspection and treatment of pupils
  • Services relating to contraception 
  • Health promotion services • Services in connection with drug and alcohol misuse 
  • Any other services that the secretary of state may direct. 

These regulations were repealed, and the act does not require CCGs to secure the above services. They have to arrange only ambulance services and “emergency care” for everyone living in the area defined in their constitutions.

The H&SC act therefore established a legal basis for CCGs to secure fewer government funded health services. The act also transferred from the secretary of state to CCGs the power to determine what is “appropriate as part of the health service” for certain individuals.

The services concerned are care of pregnant and breastfeeding women, care of young children, prevention of illness, care of people with illnesses, and aftercare of people who have been ill. In this way CCGs may decide what is appropriate for government funding.

Moreover, decisions about what is appropriate can be delegated to commercial companies and, under rules set out in schedule 2 of the act, need not be made by general practitioners, other clinicians, or NHS staff.

All the above was predicted in an article from 2011 by the BMJ, and it is now all coming to fruition.

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