Opposition mounts to extension of special administrator powers

Ministers last week won a House of Lords vote on an amendment to the Care Bill which would allow administrators to impose changes on organisations that neighbour those deemed to be failing.

The changes would make it easier for the administrators and the government to force through reconfigurations.

The Care Bill is due to finish its third reading in the House of Lords for its third reading before moving to the House of Commons.

A Labour spokesman said: “Labour will continue to oppose the amendment. If it is passed, NHS hospitals will be at risk of having services shut down without their agreement.

“This is not a clarification of the law, as the government says, but a major policy change.”

Now the Royal College of Physicians, which has spoken out in favour of clinically-led reconfigurations, has revealed to HSJ it has concerns over the plans. One member of the college’s council described the government’s actions as an “abuse of the democratic process”, by enabling proposals to be forced through without the consent of local communities.

Concerns over the amendment also emerged in a letter by RCP council member David Nicholl which was sent to the college president Sir Richard Thompson on Tuesday.

Dr Nicholl, a consultant neurologist at Sandwell and West Birmingham Hospitals Trust, said he believed other royal colleges and the British Medical Associations should oppose the changes.

He said: “There is a bitter irony here if you remember ‘no decision about me without me’. All of us want to see high quality care but this is not the way to do it; sneaking things through the back door at the last minute with minimal debate through an unelected house. I am utterly appalled.”

In his letter, Dr Nicholl said: “I am extremely worried over this legislation, which represents a total abuse of the democratic process and has the potential to threaten any hospital, with minimal consultation.

“Clearly there can be grounds for hospital reconfigurations where this improves the quality of patient care, however it is essential that this takes place with proper regard to due process. I believe the college should make an explicit statement against this amendment which stands against the principles of transparency and consultation that the public and physicians would and should expect.”

In a statement the RCP said: “Undoubtedly, a failing trust has an impact on the surrounding providers, but handing powers to special administrators to make decisions about neighbouring trusts is cause for concern. Any decisions affecting the broader health economy should be clinically-led, should be driven by the best interests of patients and should involve the wider health community from the beginning.”

The amendment was introduced after the government lost a High Court legal battle to downgrade services at Lewisham Hospital Trust.

The court ruled the special administrator brought in to deal with problems at the neighbouring South London Healthcare Trust did not have the power to suggest changes at other trusts. The government will next week appeal the Lewisham ruling.