58 votes. That was what won the day for Health Secretary Jeremy Hunt – giving him new powers to shut down local hospitals and sparing him the potential future embarrassment of his opponents challenging his decisions through the courts.
By passing an amendment to the Care Bill, Parliament has allowed the Health Secretary to avoid a repeat of what was to all intents and purposes a debacle over the future of Lewisham Hospital, the future of which was threatened by the Department of Health’s efforts to break up a neighbouring but financially unsustainable NHS trust. Campaigners forced a judicial review, Mr Hunt was ruled to have overstepped the bounds of his authority, the plans were mothballed, Mr Hunt was left with egg on his face.
No longer. Mr Hunt now has the power to close hospitals, even if they are financially sustainable, to reconfigure services and deal with failing trusts. In gaining these powers, the Department of Health has been spared a potentially sticky problem and been granted the ability to consolidate, particularly in the case of specialist services – creating what are in effect centres of excellence that the Government will claim can better support patients than a myriad of local units that individually lack funding and resources.
There are strong arguments for and against such reconfiguration. Proponents will claim it improves patient care by focusing resources and expertise; opponents will claim it leaves patients isolated and with too far to travel for suitable care, potentially putting them at risk. What is not in doubt, despite any concessions the Government made to pass the amendment, Jeremy Hunt is now less likely to be taken to task by the judiciary over his decisions.
This puts supporters of local hospitals in something of a quandary, as by removing a reason for seeking a judicial review, Mr Hunt has taken away a major weapon from the arsenal of his opponents. How can campaigners possibly make their case if a legal recourse is now at arm’s length rather than at their fingertips?
As with any public affairs and public relations campaign, the trick will be demonstrating the benefits of retaining local hospital services, seeking high profile supporters and endorsements, and by demonstrating both the political risk involved in reconfiguration and the benefits of retaining the status quo. That said, the burden of proof is likely to now fall on campaigners rather on the Department of Health, which is now much better placed to weather short-term opposition to any changes to local hospital services.