Westminster Watch by Lord Rennard

February 2015

Most people think that the government should consider using more private companies in the NHS “when they can provide high quality services more cheaply.” 

That’s according to an opinion poll recently commissioned by Tory peer Lord Ashcroft.  There is in reality little disagreement between the main parties about this approach, but the polling also shows that there is still a sharp divide in public opinion over which party is most trusted on the NHS.

Labour has a lead of 18% over the Conservatives on the issue of the NHS and so are making fears for the future of the NHS under the Conservatives central to their election campaign.  Ed Miliband has refused to confirm whether or not he used the word “weaponise” to describe his approach to campaigning against the Conservatives on the issue.

The coalition’s failure to convey to the public any explanation for launching a major re-organisation of the NHS (described as “Liberating the NHS” in the initial white paper) is confirmed in this market research.  People assumed that it been introduced to save money or that it was more “part of a plan to privatise the NHS” than to cut bureaucracy or give more choice and control to patients.

The recently appointed Chief Executive of NHS England Stuart Stevens set out a five year plan for the NHS last autumn.  It sets out the scale of the funding challenge and could provide the basis for informed debate about health funding in the General Election.  Stevens warns that a combination of growing demand, a failure to make further annual efficiencies, and flat real terms funding could, by 2020-21, produce a mismatch between resources and needs of almost £30bn a year.

On the other hand, he says that if the NHS budget remains flat in real terms from 2015-16 to 2020-21 and the NHS delivers its current long run productivity gain of only 0.8% the NHS will suffer a shortfall of £21bn. This shortfall, he thinks, can be removed if efficiency gains reach 3%, but suggests that this would require upfront investment, and major reform including integration of social care and health.

Real integration of health and social care will only occur when they are funded from a single budget and the process of achieving this will require considerable decentralisation from Whitehall to the big cities, “city regions” and “combined local authorities” that could take on enhanced powers and responsibilities, including in relation to finance. 

Both Labour and the Lib Dems will be offering further funding for health and social care through some targeted tax changes.  Labour are proposing to use the proceeds of a “mansion tax” on properties worth over £2million.  The Lib Dems are promising £8billion pa in extra funding by 2020 through measures such as restricting taxpayer subsidies to pension contributions by higher rate taxpayers.  The Conservatives may be less resistant to some extra taxation if it is levied locally as a result of devolution.

There is, therefore, much potential for assistive technology and healthcare businesses to grow, but also an expectation that they will have to help provide efficiency savings.

Lord Rennard

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Westminster Watch, April 2014 - by Lord Rennard

The BHTA ‘Manifesto’

In the last three years that I have worked with the BHTA, many themes have been constant.  

Of course every business wants to make more profit. Every politician wants to be seen supporting their constituents getting the best products and the best services.  Every government is also keen to keep down costs to the taxpayer.  

The next general election is barely a year away. All the major political parties are now preparing their manifestos for the May 2015 general election.  So this is a good time for the BHTA to prepare a short paper for government, political parties and parliamentarians highlighting the importance of our sector. 

A ‘manifesto’ from the BHTA will show how we can help the growing number of older people to live an independent life for longer, to get the best products and services and at the same time help government to significantly reduce costs in the acute sector of the NHS and at the same time reduce peoples’ dependency on benefits whilst increasing tax receipts.

Understanding of the issues and commitment to action by government will be needed to achieve all these goals. 

The BHTA manifesto will therefore be looking at:

1.       Better value for public expenditure on health and social care.

We want to help reduce the secondary care burden in the NHS. We want to help the prevention of bed blocking and provide more intermediate care for swifter rehabilitation. We want to ensure that there are supporting mechanisms to make our products and services readily available in the primary care sector 

2.       Supporting and enabling people who need equipment and related services

We want to see more patient choice to obtain the most appropriate and best products and services and we recognise the need for personal budgets to give people more independence.

3.       Creating jobs and supporting growth in the British economy

We need government help to promote manufacturing, to skill up the workforce and remove barriers to innovation.  We need it to address procurement and tendering issues and relieve unnecessary regulatory burdens.

All the party manifestoes will have to recognise that the population is ageing. Over the next 20 years the population aged 65-84 will rise by 39 per cent and those over 85 by 106 per cent. The demographic changes forecast over the next twenty yearsare going to create a demand which cannot be funded entirely from savings in secondary care.  In any event significant savings are very much needed simply in order to sustain anything like the present NHS.

As a consequence of the demographic changes the public sector will increasingly struggle to provide support to all those people who would benefit from assistive technology equipment and for whom providing the equipment would be of benefit to the country in very many ways including economically.  The assistive technology sector’s role in private retail is, therefore, likely to grow and become increasingly important in supporting and underpinning public sector provision.  The BHTA anticipates that the value of the UK market will rise from £2.5 billion sales (by BHTA members to all customers, including government and public) to £6 billion by 2025 simply to keep up with demand, without including service costs.

We can help achieve savings where provision of equipment eliminates, or reduces the need, for people intervention, and for costly stock-holding, by the public sector.  Less visible, but equally important, are savings brought about through improvements to quality of life and general mental health and well-being, reducing the call on other publicly funded services. Enabling people to stay at home saves manpower and service costs in secondary care.  We have a strong message!

Westminster Watch, July 2013 - by Lord Rennard

Getting the balance right for businesses and consumers

All recent Governments aim to be seen as ‘pro-business’ whilst also championing the interests of consumers.  

This has meant a lot of complex and sometimes seemingly inexplicable legislation which sometimes fails to serve either cause well.  The coalition has therefore just published a draft Consumer Rights Bill with the aim of reforming ‘unnecessarily complex, overlapping and out-of-date consumer law.’  The publication of ‘draft’ legislation in this way reflects the fact that Governments are now generally much more willing to set out proposals for examination by all concerned before they attempt to get Parliament to approve it.

In my view, but not that of all parliamentarians(!) the principle of ‘Fixed Term Parliaments’ with General Elections to be held at regular five year intervals makes it much easier for Governments to plan sensible timetables involving draft legislation. A Bill is then introduced to Parliament following proper consultation and with full knowledge of when Parliament is going to be dissolved, almost all legislation ‘in the pipeline’ scrapped, and a new Queens Speech delivered announcing new measures that might be for a new Government.  Much of my work in Parliament has been on constitutional measures such as this.  You can find more about issues I raise in Parliament from the excellent TheyWorkForYou.Com website.

The draft Consumer Rights Bill is in three parts.  Part I draws together consumers’ rights for the minimum quality of goods and services - rights which are currently contained within eight separate pieces of legislation (whilst adding a new ‘digital content’ category). The reforms intend to make it easier for consumers to understand their rights, whilst establishing clear mechanisms when rights are breached.  Part II clarifies which contractual terms may be challenged in court, and Part III (which consolidates no fewer than sixty pieces of existing legislation!) crystallises the powers of consumer law enforcers, such as Trading Standards, to investigate breaches of consumer law. This third section also seeks to enable consumer law enforcers to oblige traders to compensate consumers when in breach; as well as to provide faster and cheaper remedies for consumers and businesses when competition law is violated.

Reducing the regulatory burden

The Government aim is to reduce the regulatory burden on business by making markets work better. The Department for Business Innovation & Skills (commonly known as BIS) recently reported that consumers spend over 59 million hours a year dealing with problems relating to goods and services. They want to see businesses having fewer (and less costly) disputes with customers. They say that rights should be clearer for both consumers and businesses. 

In seeking to reduce the disruption caused by unplanned enforcement officers’ visits, the Bill proposes to give reasonable notice to businesses when carrying out routine inspections. A two-day notice for routine inspections is suggested.  No doubt some businesses will welcome this, whilst others may say that it could weaken enforcement.  

Businesses should now be considering the likely changes that will arise in Consumer Rights law and ensuring that their operations are aligned with the new proposals. Companies’ terms and conditions and complaints procedures will need to reflect both the spirit and the intention of the proposed legislation.In summary, BIS says that, “Consumers struggle to enforce their rights because UK consumer law is unnecessarily complex, ambiguous in places and has not kept up with technological developments” They say that this Bill will:

  • streamline key consumer rights covering contracts for goods, services, digital content and the law relating to unfair terms in consumer contracts into one place
  • clarify the law where it is confusing, or written in legal jargon
  • modernise the framework for the digital age
  • deregulate to reduce business burdens and costs
  • strengthen measures to protect consumers, where it is appropriate to do so

For more information on the draft Bill, visit the BIS Bill http://discuss.bis.gov.uk/consumerrightsbill/

FAQs: http://discuss.bis.gov.uk/

and for all Bill documents: https://www.gov.uk/government/publications/draft-consumer-rights-bill