Health and Social Care Bill

Lord Norton

The Constitution Committee has published a report on the Health and Social Care Bill.  The remit of the committee is confined to the constitutional implications of the Bill and we are concerned that the Bill, in its current form, risks diluting the Government’s constitutional responsibilities with regard to the NHS.  You can read the report here.

14 comments for “Health and Social Care Bill

  1. Gar Howell
    04/10/2011 at 4:23 pm

    the Bill “strengthens the overall
    accountability of the Secretary of State for Health”,
    citing clauses 49 and 50
    as support for this view. Under clause 49 the Secretary

    I have to admit to being an IvanIllichianist
    (the late catholic philosopher) but perhaps I can stand for myself, by saying that although
    I really shall be a fairly dedicated socialist until my passing, strengthening the overall accountability might well entail bothering less about it.

    In the classic ambulance strikes of the late 70s’/80s in USA/UK the mortality rates went down considerably because surgeons could not get their knives in to their patients as quickly as they normally do.

    I am not suggesting that this should be anything more than a temporary measure, except for the argument of “Medical Nemesis;
    the expropriation of death”. The decisions of angels as to whom should live a little bit more and who should die by the syringe now, is surely not something over which the public, in the form of the secretary of State, should have more say rather than less.

    There is a good deal of argument about whom to permit to die with assistance, but in the case of “Organ donors on wheels”(Motor cyclists)being vigorously persuaded to die, is not something the state should have anything to do with at all.

    In both these cases the accountability of the state is a thoroughly negative influence on the healthy outcome of the ailment.

    If you believe in the ideal world where we will all march, programmed, to the “death chamber” at the age of 100, never having anybody had a day’s illness, then state intervention at all times may be advantageous

    Genetic breeding,and selection was part of the Fascist ideology of the WW2 era,and euthanasia death as well, but the similarities are rarely mentioned because the state is involved, if it wants to be so.
    It’s democratic so it’s ok.

  2. baronessmurphy
    04/10/2011 at 5:46 pm

    The constitutional position is an interesting one Lord Norton. It seems to me that the de facto role of the Secretary of State has not been accurately described since the last services moved out of the direct management of the Department of Health in about 1989. The current attempts to improve the description of the role to make it clear what he/she actually does in relation to NHS bodies has obviously caused some difficulty. I believe a number of people will come forward with suggested amendments to clarify the role. There doesn’t seem to be any doubt that the National Commissioning Board (NCB) is directly accountable to the Secretary of State and the Clinical Commissioning Groups will be directly managed by the NCB. It seems to me that the direct chain of command is thereby preserved. There can be no reconfiguration without the agreement of the Secretary of State. It’s very hard in practice to see how the change of wording could impact in a negative way on service delivery. Or is that an irrelevance? I feel sure that a form of words can be found which preserves the crucial political accountability of the Secretary of State but without implying he is responsible personally for every bedpan.

    • Frank W. Summers III
      04/10/2011 at 7:29 pm

      Baroness Murphy,

      In regards to your last point it is difficult to find a number but may I suggest fifty bedpans per year be emptied and replaced by the Secretary of State. These could be determined by lottery and could be promoted in the media so that whenever anyone in the UK became ill they would have the little emotional boost that comes with knowing a high ranking official may call on them in their hospital gowns and remove their bodily waste. UN resolutions might follow in time…

  3. MilesJSD
    04/10/2011 at 6:27 pm

    “Health” means “Illness” –

    the National Health Service has in fact always had to be a Hospitals, Illnesses, and Pharmacologicals Prescriber;

    and by large accord amongst governance and medical people and amongst many levels of thinking people, the NHS has never been the major health-maintenance and lifelong health-building service it is advertised to inclusively be.

    What is worse is that it usurps health-maintenance and health-building needs, very much as a biggest-in-Britain ‘dog in the manger’. the NHS is Britain’s biggest employer.
    AgeConcern (amongst other British services) also spends our money, promoting “Your Health and Home” – “Your Health Services”;
    which turns out to be 100% rubbish.
    Read right through their 20 pages which start definitively with
    “There are lots of ways you can get help when you are ill, or when you need advice about your “health”…pharmacists, GPs, walk-in-centres and telephone services such as NHS Direct, as well as using 999 for emergencies…There are also suggestions on what you can do to encourage your future good health… The ‘Useful organisations’ section gives contact details…including NHS Direct…that may be helpful to you in your situation”
    and then droning on exclusively about Illnesses-curing and management;
    and fnd none of these “helps” are about your un-equivocal and daily-improvable Health-Needs as advertised.
    Turn to Social Care for help, to become a socially-healthier individual, and you are told definitively that Britain’s Social Care is not about anyone being or becoming healthy or healthier – you have to go to the Doctor for that.

  4. Gar Howell
    04/10/2011 at 7:48 pm

    Secretary of State has not been accurately described since the last services moved out of the direct management of the Department of Health in about 1989.

    And became known as “Agencies”?

  5. Gar Howell
    04/10/2011 at 8:12 pm

    Secretary of State has not been accurately described since the last services moved out of the direct management of the Department of Health in about 1989.

    And became known as “Agencies”?

    accountable to the Secretary of State and the Clinical Commissioning Groups will be directly managed by the NCB.

    Accountable to == agency of; does not need to be directly managed.

    Managed by= well … yes; managed.

    The worry is certainly about the meaning of “accountability”. Unless the system of agencies has come in to disrepute in the NHS, as it has in other depts of state, there is surely no need to redefine it.

    A radical move would be to take all accountable boards back in to management, which for the sake of the meaning of a word would be unwise.

    Don’t managers earn far less than Chairmen of boards, and yet feel they have the whole weight of delegated responsibility from the minister upon themselves….. but chairmen of boards?

  6. tory boy
    04/10/2011 at 9:48 pm

    Tonight I attended the committee stage of the Welfare Reform Bill in committee room 4A. I have to say I thought the Whips Office have done a good job all members needs were provided for, there was plenty of room for wheelchairs and members did not need to press a button to speak. What did irritate me was the mischief making which Lord Foulkes did, I suspect he was put up to it by the opposition whips office, mind you he was a trouble maker in the Commons. Members were complaining about the current problems facing usual channels, Baroness Royall muttered “it was not the usual channels”, and supported calls that it was the govts heavy legislative load. I disagree!
    The reasons of why committee stage has been taken off the floor of the House are quite clear; namely that due to the opposition trying to destroy consensus building in the usual channels, by stopping bills being taken in Grand Committee, this means the legislative programme has been held up. There is now a real need to take bills in Grand Committee to free up time for other bills on the floor of the House.
    The government proposed a reasonable offer of splitting the Welfare bills committee stages between Grand Committee and the floor of the house, (the controversial bits of the bill being taken on the floor of the house the other bits in Grand Committee). Yet the opposition threw out this offer. They need to realise that they are not in government anymore and are not the decision makers; therefore they should be MUCH more flexible and stop trying to bring chaos on the govt whips office.
    I have been following the House of Lords for a long time and can remember the huge legislative programmes under Tony Blair (and the many long and pointless Home Office Bills which were never enacted!) When the Conservatives were in opposition they never tried to ruin consensus building through the usual channels. They seemed to be accommodating in allowing bills to be taken in Grand Committee, (unlike the Labour party at present in the Lords.) I cannot understand why Baroness Royall and Lord Bassam are conducting the Labour party in such a sinister manner in the Lords (just look at how they behaved over the Parliamentary Voting and Constituencies Bill.) Perhaps they feel that as no party won the last election this means they can behave badly in opposition and not abide by the usual consensus building in the Lords. However people have long memories and if the Labour party return to govt (I hope they never do), the then opposition party may give them some of their own medicine.

  7. 05/10/2011 at 10:08 am

    I would urge all to look at the Equality Impact (EIA) assessment of the Health and Social Care Bill. The EIA would seem to have a hidden aim to introduce Fluoridation of all public drinking water Nationally, with no asserted right for consultation!

    In regard to Fluoridation the Bill gives sweeping powers to the UK Secretary of State (SoS) – currently Health Minister Andrew Lansley – while cutting out local opinion and ignoring current fluoride science… or at least, that’s what the current wording of the Bill implies.

    In the past, it was the Strategic Health Authorities (SHAs) that decided whether fluoride should be added to the drinking water of different counties or districts in the UK.

    There has been quite an uproar about these quangos ignoring Local Democracy in the Southampton area – and Nationally – but the new bill would seem to cynically take control completely away, under a smoke screen of supposed democracy through local Authorities!

    As soon as this new Bill comes into effect, it seems to say that it will pass the decision of ‘water fluoridation’ to Local Authorities since they have to answer directly to the people who voted for them. On paper this all looks good…

    Unfortunately, in reality, this won’t be the case. Under the Health and Social Care Bill, the final say will lie with the Secretary of State (SoS) – unlike the requirement to ensure NHS services are effectively provided (as is well pointed out by their Lordships report

    This means the SoS has the power in regard to Fluoridation
    * Decide how any consultation over proposed fluoridation will take place, without consulting the public.
    * Choose the members of the committees and Boards involved in making the decisions about fluoridation.
    * Decide what procedures the decision-making bodies must follow.

    Talk about a skewed democracy! No right to ensure we have NHS services on the one hand in the Bill, and the right to ensure Fluoridation on the other….just what is going on here?

    When one takes into account the growing major medical concerns with diluting toxic fluoride compounds in drinking water and its negative effect on adolescence’s teeth (Flurosis from overdosing at over 40% in the USA), and the growing evidence of wider health issues affecting the endocrine system, bones and major organs and IQ.

    The Bill is asserting an illegal and unethical position in regard to medication without consent AND without regard to an individual’s underlying health status. With fluoride in the drinking water there is no set individual dosage and it is irrelevant if they have any underlying condition, such as being a baby, pregnant or have a kidney disease etc.

    This cynical use of this bill, and its EIA, to tip all the power and decision making in regard to Fluoridation into the hands of the SoS and associated cronies, which is asserted in the Bill as currently drawn, is outrageous in a democratic society, and potentially litigious.

    It is also very bad law.


    • maude elwes
      05/10/2011 at 12:42 pm

      @Jonathan Eyre:

      First of all adding fluoride to the water system whether by consent of the people,which means a majority, cannot be legal, as a majority cannot give consent for the rest of the community on an issue such as this. Fluoride is toxic.

      This means that what may harm one erson may not do so to another. Example: University friend in LA suffered complete rotting of teeth due to fluoride added to the water he drank. His teeth went bright green, before dropping our over time. So, this didn’t do a thing to save his teeth did it? And at 25 he had cancer of the bones.

      Secondly, it has been connected to stomach cancer. Which means those of us who do not want our families to be zorched by this chemical will be forced to buy water to cook in as well as to drink.

      Now why would government want to do this? Could it be friends in the water selling business will benefit enormously as well as those other pals, selling the fluoride.

      Fluoride in toothpaste is way and above the level needed for any perceived protection that may be gained from being forced to swallow this guff. So, if government, once again, wants to be bountiful with tax payers money, they claim they have to keep our sick and disabled looked after, why not supply the needy with this product? Toothpaste manufacturers will be very happy with that policy and no doubt will give back handers as a result.

      Regardless, the big answer is, for the names of those ministers and sanction givers to such poison to be added to our water, to enable them to be sued by those who develop allergies, disease or have their teeth drop out as a result. The dead, of course, will have no come back. These people are well aware of the history of this product, they are well aware of the risks, yet still without the incdividuals knowledge or consent, they pushed it on them. Not giving one thought to their welfare.

      Direct and peronal accountability is the only way to go with these irresponsible government officials. Then, we will see change in attitudes.



      We need to consider taking government officials to court over decisions they knowingly make that can injure and kill the population with ‘their’ sanction to do so.

  8. Gar Howell
    05/10/2011 at 3:49 pm

    Amazing how the meaning of the word “accountability” can turn in to the value of fluoridisation in the twinkling of an eye !!

    The whole point about nit picking constitutional jargon is that much the best way is “if it works, use it!” If it does not, change it!

    It still seems to work, however much we may dislike the NHS.

    • maude elwes
      05/10/2011 at 4:25 pm


      How would you like to see it turn then, accountability, that is?

      Or, do you feel accountability is only acceptable as a ‘one issue’ matter.

      Choose your accountability project people, there can only be one hit.

  9. 05/10/2011 at 4:09 pm

    @ Maude

    ” Regardless, the big answer is, for the names of those ministers and sanction givers to such poison to be added to our water, to enable them to be sued …..

    Direct and peronal accountability is the only way to go with these irresponsible government officials. Then, we will see change in attitudes.”

    Absolutely agree with you on this. Litigation is starting in the USA; UK next.
    Good to hear from you.

    • maude elwes
      06/10/2011 at 2:38 pm


      I cannot say ‘my pleasure’ because, it is no pleasure to have to accept we have such people who would consider this as an option in our government.

      Regardless, it was a nice comment. Thanks.

  10. Hansard Society
    Beccy Allen
    10/10/2011 at 10:18 am

    A link from Dr Grumble on the Twitter feed that he thought might be of interest on this subject:

Comments are closed.