One of the more tiresome ways of our legislators is their habit of changing law through the use of amendment clauses. You know the sort of thing: instead of rewriting the clause from scratch, and presenting it in its entirety, we have ‘In section 650 of the National Health Service Act 2006 (Chapter 5A of Part 2: interpretation) (the existing text of which becomes subsection (1)) at the end, insert—’, the end result of which is a serpentine spaghetti of words so convoluted that the eyes glaze over and the temples throb. Never mind that the apparent zero after 65 is in fact the letter ‘O’, or that the said Act 2006 appears in fact to be said Act 2009; the fog generated while trying to cobble together the parts to make an intelligible whole is a masterpiece of Sir Humphreian obfuscation.
As it happens, ‘In section 65O of the National Health Service Act…’ is a real extract from a real clause currently on its way through parliament. The clause is clause 118, the bill the Care Bill, which had its second reading last Monday, the Bill itself being something of a Trojan Horse for the boring sounding clause 118, which is not in fact about care at all, but the powers available to administrators of NHS hospitals placed in ‘special measures’. Known sometimes as ‘The Lewisham Clause’, it was trojaned into the bill to fix ‘The Lewisham Problem’.
You may already be vaguely aware, or if you live in the area acutely aware, of the Lewisham Problem. After the South London Healthcare NHS Trust was placed in special measures last year, the administrator, after a rushed and bodged ‘administration’ chiefly aimed at balancing the books, recommended that the Secretary of State fix the failing trust by nuking a neighbouring but unrelated and indeed successful trust. Lewisham Hospital would lose it’s A&E, maternity and paediatric services to balance the books of the failing SLH Trust. Local opposition placed the matter in the courts, where the SoS was firmly told that he was acting unlawfully. That, in a nutshell, is the Lewisham Problem: you can’t legally hit a viable trust to save a failing trust.
So what does a good politician do when he has fought the law, and the law won? Why, he changes the law, of course! But, instead of doing so openly, with proper focus and debate, which would almost certainly see the change fail, the SoS has tacked the necessary change, by way of one of those serpentine spaghetti clauses, into the back half of another related-but-not-really-related bill, the Care Bill, as clause 118.
The actual wording of the key bit (it is duplicated – more obfuckstration – to cover foundation as well as non-foundation trusts) is to insert into the Act ‘The references in this Chapter to taking action in relation to an NHS trust include a reference to taking action, including in relation to another NHS trust or an NHS foundation trust, which is necessary for and consequential on action taken in relation to that NHS trust [emphasis added]’. There are of course other changes, but the meat of clause 118 is that it allows steamroller action ‘in relation to another NHS trust or an NHS foundation trust’, against a backdrop rushed and most likely fudged consultation, for financial rather than clinical reasons.
So long as clause 118 stands, no NHS hospital is safe. LaLa abolished the duty to provide; now we have Hunt assimilating the power to destroy.