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Health Service Jeremy Hunt ‘undermining founding principles of NHS’ with ‘accountable care organisations’ scheme

SAM TOBIN reports from the High Court

JEREMY HUNT was accused yesterday of trying to “undermine the founding principles of the NHS,” as a judicial review of reforms that would open up the health service to private companies began at the High Court.

The Health Secretary proposes to create so-called accountable care organisations (ACOs), which campaign group JR4NHS warns will make “radical and significant” changes to how services are commissioned and delivered.

They would create “a secondary, non-statutory, non-accountable decision-maker … which will be taking decisions about what will and will not be made available free at the point of use,” the court heard.

The group, founded by three doctors and a professor and civil servant, was supported by top physicist Professor Stephen Hawking, who branded ACOs an “attack on the fundamental principles of the NHS,” until his death in March.

The judicial review brought against Mr Hunt and NHS England alleges that the changes breach the NHS Act 2006 and have been carried out without transparency.

Jenni Richards QC said the four claimants had brought the case “not on a whim, not to be difficult, not … for political reasons, but because of their concern about [the] policy.”

She said that, unlike clinical commissioning groups (CCGs), ACOs had “no statutory functions” and would not be subject to the “statutory regime of checks and balances” and that they were “in effect replicating the function of the CCG,” which was “impermissible” under the 2006 Act.

Ms Richards said ACOs “could easily be a private for-profit body [which] will be responsible for, and in charge of, healthcare for the entirety of a given population, holding the majority of the health budget for that population for a decade.”

She added: “It could be an NHS foundation trust, it could be Capita, it could be Virgin Care.”

Ms Richards noted the “extremely wide” range of services which could fall under an ACO contract, including A&E, cancer, diagnostic, mental health and learning disability services and palliative care.

She also criticised the attempt to push through “substantial organisational change … in the absence of parliamentary scrutiny or public engagement in the debate” and said the claimants’ concerns had been “partly vindicated by the defendant’s agreement to undertake a national consultation.”

But she pointed out that the consultation announced in January, which was a “significant concession,” had “not yet materialised.”

Ms Richards added that Mr Hunt and NHS England had “failed to act in accordance with the duties of transparency and clarity.”

She said those concerns had been “magnified in the course of proceedings” by recent statements on what an ACO would be, which had hidden or obstructed that which was previously explicitly stated.

Professor Sue Richards told the Star Mr Hunt’s changes would “completely destroy the democratic nature of the NHS and would be an opportunity for big corporates to come in and play an important role in the providing or the making of key decisions.”

She added: “Even if we lose this case, we feel we have succeeded in creating an opportunity for real public debate.”

Fenella Morris QC, for Mr Hunt, said the policy was “intended to improve patient services through greater integration of different health and social care services.”

She added that while Mr Hunt supports the policy, “the policy is that of NHS England.”

The hearing continues.

During Prime Minister’s questions yesterday, Jeremy Corbyn challenged Theresa May on the extent of privatisation of NHS services.

The Labour leader said that the value of outsourced services stood at £4 billion in 2010, but Ms May was unable or unwilling to give an up-to-date figure.

He highlighted a National Audit Office warning that Capita’s £330 million seven-year contract to provide back-office support for NHS England services had “put patients at risk of harm.”


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