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A group of 36 MPs and Lords, including several from Merseyside, have written to Ed Argar, the government’s Minister for Health, with concerns about provisions in the Health and Care Bill to revoke the national tariff and replace it with a new NHS payment scheme.
The national tariff is a set of rules and prices which determine the amount providers are paid to deliver around 2,400 treatments in the NHS.
The politicians write that they have ‘serious concerns about the implications the proposed NHS payment scheme could have for those who work in the NHS’ with a key concern being that, given NHS England is to consult with both NHS providers and those from the independent or voluntary sector before publishing the scheme, it ‘will, in effect, give private healthcare companies the opportunity to undercut NHS providers’ and that we will see ‘healthcare that should be provided by the NHS increasingly being delivered by the private sector’.
If that happens, the MPs and peers believe that NHS staff may find themselves forced out of jobs that are currently on Agenda for Change rates of pay, pensions and other terms and conditions, with only private-sector jobs with potentially lesser pay and conditions available for them to apply for if they wish to continue working in the health service.
An amendment to the Health and Care Bill tabled by Margaret Greenwood MP, the MP for Wirral West who also organised this letter, aimed to ensure that the pay rates of Agenda for Change, pensions, and other terms and conditions of all eligible NHS staff are not undermined as a result of the adoption of the NHS payment scheme.
Another amendment by Margaret Greenwood called for a provision in the bill for all relevant trade unions and other organisations representing staff who work in the health and care sectors to be consulted by NHS England on the likely impact of the proposed NHS Payment Scheme.
During the recent Committee debate, the Minister for Health Ed Argar said he appreciated the ‘impulse’ and the ‘intent’ behind this amendment and that ‘it does highlight issues that (the government) need to put on the record’.
Despite this, he said that ‘the Bill already requires NHS England to consult with integrated care boards, relevant providers and any other person the NHS thinks appropriate before publishing a payment scheme’.
However, the MPs and peers argue that this does not go far enough and that it does not provide NHS staff with any guarantee on this point. They have now asked the minister to set out:
Margaret Greenwood, the MP for Wirral West who organised the letter, said, “The Health and Care Bill is a pernicious piece of legislation that breaks up the National Health Service into around 42 locally managed ‘systems’.
“It is vital that the private sector is not given the opportunity to undercut the NHS; there are very real concerns that the provisions for the abolition of the national tariff and the introduction of an NHS payment scheme will do just that. The impact that this could have on NHS staff is not to be underestimated.
“If there is an increase in the amount of health care provided by the private sector and a reduction in the amount by the NHS, as the provision in the bill may lead to, this would mean that fewer health workers would be eligible for Agenda for Change pay and other terms and conditions, including pensions.
“There are real concerns too about what these changes would mean for patients. If, as the government’s explanatory notes to the Health and Care Bill state, there may in the future be no national tariffs, we could well see greater regional variation on pay emerge, along with variation in the level of expertise available in different parts of the country. This has serious implications for patients too.
“For example, if it is deemed cheaper to deliver a particular treatment in the north of England than the south east, there may, over time, be a reduction of the availability of such treatment in the south east.
“The government must look again at this issue and provide NHS staff and patients with the guarantees that are needed in legislation to protect the pay, terms and conditions of staff and to ensure the comprehensive availability of services across England.”
As well as Margaret Greenwood, the letter has also been signed by local MPs Angela Eagle (Wallasey), Paula Barker (Liverpool, Wavertree), Ian Byrne (Liverpool, West Derby), Dan Carden (Liverpool, Walton), Peter Dowd (Bootle), Maria Eagle (Garston and Halewood), George Howarth (Knowsley) and Kim Johnson (Liverpool, Riverside).