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New bill will allow Government to reconfigure successful hospitals without GP commissioners’ support

The Government is to change the law to allow it to reconfigure successful hospitals without the support of CCGs, after it was reprimanded in a recent High Court case.

A clause in the Care Bill, which is currently before the House of Commons, will give new powers to ‘trust special administrators’ (TSAs) – who are called in to failing hospital trusts – to reconfigure services across a whole health economy, and not just the failing trust itself.

This follows the High Court’s decision to find in favour of a judicial review against the health secretary’s decision to downgrade the successful Lewisham Hospital A&E on the recommendation of a TSA appointed to look at the nearby failing South London Healthcare NHS Trust.

Clause 118 of the Care Bill could allow fast-track closures – or potentially privatisations – to happen to any hospital, however high quality, popular and solvent, if it has a more struggling hospital nearby.

The bill, which started in the House of Lords, is due to have its second reading in the Commons next week (16 December) and Clause 118 is the subject of a petition by the campaign group Our NHS.

In an open letter to MPs, the group said: ‘Currently the law allows such undemocratic and fast-track closures to happen only at hospitals that are in such serious financial or clinical difficulties that they are taken into administration.

‘But the hospital closure clause would change the law. It allows fast-track closures – or privatisations – to happen to any hospital, however high quality, popular and solvent, if it has a more struggling hospital nearby. And given the cuts currently being inflicted on the NHS, there will be few hospitals in the country that aren’t somewhere near a struggling hospital.’

Lewisham GP and NHS Alliance member Dr Brian Fisher said the current legislation was designed to enable health secretary Jeremy Hunt to make fast decisions about a trust that is failing financially and follows on from the Lewisham decision.

Writing on Pulse, he said: ‘So far as accountability is concerned, the clause makes clear that local authorities can’t scrutinise new proposals, the time for consultation is increased to 40 days, CCGs do not have to consult their populations about the proposed changes and even if CCGs in the affected area disagree, a final decision can be made by NHS England.

‘GPs up and down the country are likely to be dragged into arguments and frustrations as solutions are imposed. Next time, it could be you facing down the TSA.’

A DH spokesperson said: ‘It is in everyone’s interests – patients, providers and commissioners – that we have an effective regime for dealing with unsustainable trusts.

‘Patient care can be affected by issues in neighbouring NHS hospitals, so it makes sense for the trust special administrator to be able to consider the wider local health economy.

‘The trust special administrator must consult the views of the public, clinicians across the whole area, and the trust in difficulty – to make sure their recommendations deliver the best possible care for patients, wherever they live.’