While Aunt Sally and her straw man continue to bicker about just how much extra competition Mr Lansley is or isn’t introducing into the NHS, a genuine real life policy question demands answering.
Southern Cross – the UK’s largest care home operator – faces, in the words of its own chair “a critical financial position and cannot afford to meet its future rent obligations in full”. Not great news for its 31,000 frail and disabled residents.
On one side – made much of by the company itself – are the years of real terms freezes in the rate councils pay for care home places. But the company’s detractors also draw attention to how it sold on its property freeholds during the housing boom, now leaving it hostage to unaffordable rents.
In financial and social care circles, speculation is rife that the government will need to step in.
But there’s intrigue for the NHS here too: after all, the vague phrasing in the white paper and bill has been taken by many to imply social care providers will also be subject to the economic regulator.
Enter, in that case, our friend the “additionally regulated services” clause in the white paper, which killjoys have seen fit to rename “additionally licensed services”.
The clause will in effect ensure the current restrictions around NHS hospitals borrowing against or disposing of their assets continue to apply to a narrower set of designated “essential” services.
Leaving aside the inevitable debate about which accident and emergency departments are essential and where that leaves choice and competition, the Southern Cross situation poses the tantalising prospect of the regulator designating a private provider as essential.
In a world – possibly quite far off – where the Health Bill is law, would Southern Cross have been allowed to both flog off its freehold and remain licensed to provide care services? If not, what other option would have been open to shareholders to expand the company’s business?
Sally Gainsbury is a news reporter for the Financial Times.