Election result boosts NHS campaigners

The final general election result - Conservatives 318, Labour 262, SNP 35, Lib Dems 12, DUP 10, Greens 1 and others 12; total 650 - is a stunning rejection of the austerity policies of the previous Government. But it is not quite enough to end them. The DUP appear to be ready to support the Conservatives to give them the slim majority of 6 which they need to continue in power. This will in practice be 13 because 7 Sinn Fein MPs refuse to take their seats.

But this is a very precarious arrangement, and it seems unlikely to survive another year. And the Government is not even talking with the EU about Brexit!

The results in central London are spectacular: only five constituencies - Cities of London & Westminster, Chelsea & Fulham, Richmond Park, Putney and Wimbledon - remained in Conservative hands. Even Kensington was won by Labour - by 30 votes!  Further out to the north west Harrow East stayed Conservative.  This means that in the "footprint" of the NW London STP which covers 8 boroughs (not constituencies) the only ones with Tory administrations are Westminster, Kensington & Chelsea and Harrow. Pressure on the Labour boroughs which have not condemned the STP will surely increase.

Opinion about the outcome of the election on Conservative policy for the NHS and social care seems divided. On the one hand Chris Ham of the King's Fund foresees little immediate change to the direction of travel. Nigel Edwards of the Nuffield Trust disagrees. The dire state of the NHS is certainly, with Brexit, the first or second most important issue to the electorate, with every part of the UK affected by NHS cuts and closures programmes which are fiercely resisted by corresponding "Save our NHS" or "Save our Local Hospital" campaigns (Ipsos Mori 8th June 2017).

Underneath the jubilation is a nagging worry: the Conservative 2017 manifesto promised on p67 "We will hold NHS England’s leaders to account for delivering their plan to improve patient care. If the current legislative landscape is either slowing implementation or preventing clear national or local accountability, we will consult and make the necessary legislative changes. This includes the NHS’s own internal market, which can fail to act in the interests of patients and creates costly bureaucracy. So we will review the operation of the internal market and, in time for the start of the 2018 financial year, we will make non-legislative changes to remove barriers to the integration of care" [my bold]. The purpose of the abolition of the internal market is, of course, to consolidate Accountable Care Organisations (or Partnership, or Systems). The nature of the "non-legislative" changes is not specified, but in the last twenty years successive governments have made increasing use of Statutory Instruments (secondary, delegated legislation - supposedly to complete or "tidy up" primary legislation) to bring about legislative changes contrary to the primary legislation by stealth and without public scrutiny. George Monbiot explains these insidious, dishonest legislative manoeuvres.

The onus is now on all MPs to study carefully the long lists of proposed SIs and reject offending ones presented casually for voting by remaining MPs on Friday afternoons.....