Reversing Privatisation: Clive Efford MP’s NHS Bill

Labour MP Clive Efford successfully introduced a Bill that will scrap David Cameron’s market framework for the NHS and make sure local NHS patients are always put first. Now the Tory-led government is under pressure to honour this new bill and make sure it is enacted and enforced.

The Tory-led government has forced hospitals to open themselves up to a privatisation agenda which prioritises spending on competition lawyers and tendering exercises instead of on patient care.

The Bill would scrap the rules that force market tendering of services and that are seeing millions of pounds wasted on competition lawyers instead of patient care.

1. Section 75 regulations
These are the rules that many doctors say are forcing them to put services out to the market, even if they do not want to, for fear of legal challenge.
Labour oppose these regulations because they risk fragmenting care and are seeing large amounts of money spent on tendering exercises rather than patient care.

  • Freedom of Information requests by the Labour Party show NHS hospitals are now spending in excess of £60 million per year just on tendering exercises / assessing tenders for bids. In addition to this, Clinical Commissioning Groups will also be spending millions on putting services out to tender.
  • In a survey by Health Service Journal, two thirds of commissioners said they had experienced increased commissioning costs as a result of the new regulations (Health Service Journal, 4 April 2014)
  • Last year, the Chief Executive of the NHS said “You’ve got competition lawyers all over the place, causing enormous difficulty…We are getting, in my view, bogged down in a morass of competition law which is causing . . . significant cost in the system” (Sir David Nicholson, Financial Times, 5 November 2013).


The Bill scraps these rules and return to a system based on collaboration and integration. The Bill would also give contracting authorities the right to use ‘NHS contracts’ to ensure they can avoid competition law.

2. Competition framework
The Health & Social Care Act exposed the NHS to the full force of EU competition law. It also established Monitor as an economic regulator to enforce competition in the NHS, along with the Competition and Markets Authority (CMA).

Labour opposes this framework because it is hindering important service improvements simply on the grounds that they do not serve the interests of competition, and is seeing further large amounts of money wasted on competition administration and competition lawyers.

  • Freedom of Information requests by the Labour Party show NHS hospitals are now spending in excess of £20 million per year on navigating the Government’s competition law requirements for NHS reconfigurations and mergers & acquisitions
  • Monitor’s Annual Plan, shows that the organisation spent £4.9m on monitoring and enforcing competition in 2013/14 and they estimate the cost of their competition work in 2014/15 will be £6.3m.


The Bill will scrap the competition framework, remove the role of Monitor as an economic regulator enforcing competition in the NHS, and remove the Competition and Markets Authority from any role in the NHS.

3. Private Patient Income
The Health & Social Care Act allowed hospitals to raise up to half of their income from treating private patients.

Now we see hospitals expanding their private patient units, even as waiting lists lengthen for NHS patients and treatments are rationed.

The Bill would set tougher controls on private patient income to ensure NHS patients always get put first.

4. Democratic accountability: the Secretary of State’s powers and duties
The Health & Social Care Act removed the Secretary of State’s duty to provide health services in England, ending the historic political accountability for the NHS. Now ministers won’t answer for the problems they have created in the NHS.

The Bill would restore the Secretary of State’s historic duty to provide NHS services.

5. The Transatlantic Trade and Investment Partnership Treaty (TTIP)
The Bill ensures the TTIP Treaty cannot impose procurement or competition obligations on the NHS.