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Health Bill: let’s see some real transparency

The Lords must inject some real transparency into the NHS Bill.

We now know that the House of Commons have voted for the third reading of the Health and Social Care Bill; supine Coalition MPs have voted almost without opposition, since only four Liberal Democrat MPs opposed the Bill. The Bill will now go to the House of Lords where it has been predicted that the Bill will get a rough ride. Crossbench (members of no political party) and Liberal Democrat peers are reported to be particularly keen on changing the Bill.

It remains likely, though, that any amendments that change the purpose of the Bill will be overturned by the House of Commons at a later stage. The Parliament Act can then be used to impose the will of the elected House over the unelected Lords. The Lords should therefore also look at other changes that will limit the government's aim of transferring services to the private sector. Here are some amendments which I think the government will not be able to oppose.

NHS branding

The government makes a lot of noise about transparency, but they do not seem too keen to apply this to healthcare. If patients are to be able to make a real choice they have to be able to access detailed information about the providers offering the service. At the moment Independent Sector Treatment Centres can use the NHS logo even though they are neither owned nor operated by the NHS. There is a potential for patients to think that a private provider is an NHS provider. The Bill should make it clear that the NHS name and logo can only be used by NHS providers (Foundation Trusts).

Open and transparent

The NHS Choices website (used to inform NHS patients) and the Choose and Book system (used to book treatment) must be clear about the providers that are offered. There must be a clear indication of whether the provider is NHS, private sector (for-profit) or voluntary sector (non-NHS, but not-for-profit). Since NHS care is paid by the taxpayer full information must be given on NHS Choices about how much of the tariff (the payment for treatment) is used to pay for the treatment. It should also give details about the surplus generated by the provider and whether this is taken as profit and paid as a dividend (private sector), paid to employees through profit share (mutuals), or reinvested as more healthcare (voluntary sector social enterprises and NHS providers).

Governance

The government is clear that voluntary and independent sector (ie private) providers are treated on a "level playing field" with NHS providers. This should mean that any organisation providing healthcare services to the NHS must have a minimum level of governance. That is: board meetings held in public, board papers published, patient involvement in governance through patient board members or a council of governors. Furthermore, all providers must be subject to the Freedom of Information Act.

The purpose of these requirements is to allow patients to make an informed choice. Those of us who want to support the NHS will be able to use this information to only use NHS providers.

• The TUC has launched an online campaign to lobby the Lords.

Richard Blogger writes about the NHS and social policy at NHS Vault.

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