11 March 2014
Last updated at 21:08
MPs have voted through a controversial measure that gives England’s health secretary powers to close local hospitals, even if they are performing well.
Clause 119 in the Care Bill allows a hospital to be closed or downgraded if a neighbouring trust is struggling financially.
The government maintains it is a good way to address local care issues.
But critics say the powers put finances ahead of patient care.
Clause 119 gives special administrators the power to make changes to neighbouring services while trying to rescue failing NHS trusts.
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Analysis
Change is notoriously difficult. Which politician wants to make the case for closures?
Plans for change normally require lengthy public consultation, and backing from local doctors before they can be pushed through.
If that doesn’t work and the trust becomes financially unsustainable a special administrator can be appointed to draw up a fast-track plan for reorganisation, with only brief consultation.
This has to be signed off by the health secretary.
But the process came unstuck in south London where – as part of changes to a neighbouring trust – the rescue plan involved cuts to Lewisham hospital.
The court of appeal ruled last year the health secretary had acted beyond his authority.
Clause 119 of the Care Bill is designed to get round this – so if a trust is put in the hands of a special administrator, it can recommend changes across the whole region.
It was inserted into the bill after the High Court ruled last October that Health Secretary Jeremy Hunt had acted outside his powers when he decided the emergency and maternity units at Lewisham Hospital, in south-east London, should be cut back to save a neighbouring trust that was going bust – Queen Elizabeth Hospital Woolwich.
It means Trust Special Administrators who take over any failing NHS trusts in England can push through whatever other local changes they think are necessary, although they will have to consult the public, commissioners and staff.
A total of 297 MPs voted in favour of Clause 119, while 239 voted against it.
There have been several high-profile campaigns to save hospitals and services earmarked for closure in recent years, including the Save Lewisham Hospital campaign.
Labour shadow health secretary Andy Burnham told MPs Clause 119 was dangerous and wrong.
He said: “It creates an entirely new route for hospital reconfiguration – top-down, finance-led.
“It subverts the established process in the NHS which requires that any changes to hospitals should first and foremost be about saving lives, rather than saving money, and it puts management consultants, not medical consultants or GPs, in the driving seat.”
Labour says more than 30 cash-strapped trusts could face closures.
But Health Secretary Jeremy Hunt said clause 119 would help drive forward changes to ensure patient safety when trusts were found to be failing.
A Department of Health spokesperson said the clause would only ever be used as a “last resort”.
“Changes to the special administrator regime will ensure that patients get safe care, and these powers have only ever been used in extremis twice since 2009.
“It is a process of last resort, when a hospital trust faces very serious financial or quality risks,” the spokesman said.
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