Hospitals: MPs debate greater closure powers

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MPs are set to debate a controversial measure which would give ministers sweeping powers to close hospitals.

Clause 119 of the Care Bill would allow administrators appointed to oversee NHS trusts in England that are struggling financially to make decisions over the future of neighbouring trusts as well.

The measure is the government's response to a court ruling last year.

It said ministers acted illegally in proposing a downgrading of maternity and A&E services at Lewisham hospital.

Shadow health secretary Andy Burnham says the plans are "wrong on every level"

'Hospital closure clause'

The measure would allow Trust Special Administrators, appointed by the Health Secretary in England, to take over any NHS trust that is failing financially and push through whatever other local changes they think are necessary.

Last year a court ruled that Jeremy Hunt had acted illegally when he tried to do just this - by approving the closure of services in one south-east London trust - Lewisham - to save a neighbouring trust that was going bust - Queen Elizabeth Hospital Woolwich.

Ministers argue that patient care can be affected by what happens in neighbouring NHS hospitals, so it makes sense to consider the wider local health economy.

Start Quote

If this Bill becomes law, well-performing and popular hospitals will be at risk of having their services shut down without their agreement and without proper consultation with staff, commissioner, patients and the public.”

End Quote Frances O'Grady TUC General Secretary

And they insist the Trust Special Administrator (TSA) will have to consult the public, commissioners and staff - including clinicians of the trust in difficulty and other affected trusts - to make sure their recommendations deliver the best possible care for patients, wherever they live.


But unions and patient groups have campaigned against the measure arguing it will mean hospitals could be closed with minimal local consultation - and the legislation may have an impact on hospital services across England.

The Labour Party, which is opposing the measure, says services at dozens of otherwise financially sound hospitals could be put at risk.

Labour have tabled two amendments to the clause, one to delete it altogether and another which will still allow local service providers to have a say in the running of their local NHS services.

The NHS Confederation, which represents NHS hospital trusts, said an amendment was needed that would require the TSA to consult with and consider the views of the organisations affected by any broader changes.

Clause 119

The clause in the Care Bill would extend the remit of an administrator brought in to manage a failing trust, so that he or she can make recommendations about other trusts in the local area.

Trust special administrators (TSAs) would be able to consider the wider healthcare system in their investigations, not just the trust in administration.

The argument for this is that no NHS trust operates in isolation - the failure of one trust will impact on others in the local area.

But opponents say it could allow administrators to override local views and impose unwanted hospital closures on successful trusts.

Jos Bell of the Save Lewisham Hospital campaign group said: "No hospital in England will be safe under a clause 119 regime. It could be any hospital, anywhere.

"Hospitals that are successful should never be put in this position. Clause 119 should be thrown out."

TUC General Secretary Frances O'Grady said: "If this Bill becomes law, well-performing and popular hospitals will be at risk of having their services shut down without their agreement and without proper consultation with staff, commissioner, patients and the public.

"We're calling on MPs to abide by their commitment to put patients and clinical staff at the heart of decision-making within the NHS and oppose the government's ill-thought out hospital closure clause."

Rachael Maskell, head of health for Unite, said: "No decision about me, without me', is what the government promised when it forced through the Health and Social Care Act in 2012 against the views of clinicians and NHS campaigners alike. Now it wants to rush through hospital closures in 40 days with only one clinically focused meeting. It could be dismissed as bonkers if it wasn't so dangerous.

"The government must scrap clause 119 of the Care Bill and talk to the clinical experts. MPs and peers have had the wool pulled over their eyes once already with the Health and Social Care Act, they should not let themselves be fooled again."

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