One engaged voter’s view on democracy and the ‘new’ NHS

The NHS belongs to us all – Does it?

The New NHS

The ethos of the People’s NHS was killed stone dead by The Health and Social Care Act 2012 when it removed ‘universal healthcare’ as a right for every citizen of Great Britain and replaced it with the lesser term ‘comprehensive healthcare’ as a (lesser) right for the population of Great Britain – clever that last bit – makes you think it’s the same health service.

Right to Healthcare

The Act does not define what comprehensive health provision actually stands for, as far as I could see, which I think is intentional. It can now be defined on a whim depending on what the Minister for Health wants it to mean, which in practice could mean ‘We don’t have the money for that so you can’t have it’, or ‘You have no value to society so we don’t have to treat your expensive health condition’. The provision of healthcare has become a very flexible concept to be measured against worth of the individual verses value for all. In other words as an individual the electorate and their families no longer have an individual right to healthcare only a collective one.

Comprehensive verses Universal

I believe this means we now have no’ individual defined right to health care only a right based on a comprehensive’ premise. Pre 2012 treatments were withheld for some conditions under NICE guidelines but they had to be defined under certain rules that NICE had to follow. We now may only have the right to what is collectively measured and can vary at any given time, thus removing a fundamental individual right to universal healthcare provision. In fact as the new NHS facilities will be independent, under the umbrella of the People’s NHS logo it will be possible, in my opinion under this law, for the independent or private provider to refuse treatment if they run out of money or for some other unknown reason.

Just to highlight the word comprehensive: Comprehensive car insurance, comprehensive home insurance, comprehensive personal insurance, comprehensive travel insurance, comprehensive business insurance and one we all know and love: Comprehensive Payment Protection Insurance. Now I wonder why, as a patient, I do not feel very cared for or protected. The thing about comprehensive insurance provision is that there is always a ‘get out’ for the provider. In this case that is the Secretary of State for Health and the Health and Social Care Act itself.

The New System and Patient Influence

With the ‘new’ health service power is devolved down to purchasing groups called CCGs who will contract services from further devolved providers. Patient involvement in all these many levels of hierarchy; numerous government agencies, CCGs, directly contracted private companies, sub-contracted private companies, private contracted GP practices, franchised care and micro franchised care, will be very limited and will have little if any influence.


I believe this Act allows any government to withdraw any level of healthcare whenever it is decided it is too expensive or finance needed to fund something else – perhaps something that is considered a higher priority like MPs expenses or pay. That may seem farfetched but we now have to rely more on a moral, financial, pragmatic or self-interested view in provision of our healthcare rather than an individual and collective safeguarded right. I see this ‘new’ NHS as only giving me a right to the ‘consideration’ as to whether I ‘deserve’ the right to healthcare.

This Act now enables a government to determine, based on economic value of the individual, whether you are eligible for healthcare. For example; I could work my whole adult life, paying proper taxes and then get cancer. If that cancer then causes physical damage and I am no longer able to work my value to the country can be assessed as zero. It is possible that it could be measured historically to see what I might have earned in physical labour to determine what I might be entitled to but of course that is really beside the point. The 2012 Act allows a government to withdraw the monitoring of my health and any subsequent treatment by the use of data, which under the Act I cannot refuse they collect and store.

An Example

Cancer reoccurrence is very common. Under this Act a government could refuse to treat me due to low success of treatment increasing the risk of a terminal recurrence. Death from cancer due to no healthcare is a very real concept under this Act and I am especially concerned when I see cancer wait times and treatment already under severe pressure and worsening since 2010.


Despite assurances to the contrary from the current Conservative administration most of the provision in the Health and Social Care Act indicates a completely different focus regarding healthcare provision than the old one. There is far too much for me, a lay person, to analyse and comment on but the main elements put into statute a design for a completely privatised, fragmented and, in my opinion, costly healthcare corporate business structure, which will be paid for by tax payers without a fundamental and individual right to it. This may be ‘available’ from cradle to grave but I found it hard to be convinced that it was my right to have it ‘provided’ from cradle to grave. In addition I would actually hesitate to call it a service as it really just represents what will be a corporate healthcare sector similar to that provided by the USA.


The public were not told about the impending destruction of their right to universal healthcare as they were not given a choice prior to the election in 2010. This change was not campaigned on or mentioned by the Conservative Party. In fact it was stated that absolutely no reorganisation of the National Health Service would take place. Since winning the election they have systematically denied the aim to privatise the NHS whilst actually doing just that and it seems rather disingenuous to me when reading through the Act itself. The government did not hold a referendum on such a fundamental individual right, held by the citizens of this country since 1948 and once in power did not announce their intentions in a manner that gave the electorate relevant information and understanding and therefore any recourse through democracy. The media did not give an appropriate level of cover to a change of such magnitude leaving the electorate pretty much in the dark. As a result, even 4 years later, many members of the public do not know about it and are oblivious to the removal of their rights.

I am of the opinion that, not only were fundamental rights taken away from every citizen by the Health and Social Care Act 2012 but our fundamental and individual democratic right was at the very least undermined by the manner in which this Act was thrust upon us.  I have to question a country that has a process that can so completely nullify the votes of millions of people with such impunity. Our individual rights within a democratic system have been dismissed by this Government prior to and since coming to power.  I hope I will never again see this countries democracy so undermined.

Reference: as well as other sections of the Health and Social Care Act 2012, which can be found via this link or directly from the web site

Health and Social Care Act 2012

Secretary of State’s duty to promote comprehensive health service

This sectionnoteType=Explanatory Notes has no associated

For section 1 of the National Health Service Act 2006 (Secretary of State’s duty to promote health service) substitute—

“1Secretary of State’s duty to promote comprehensive health service

(1)The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a)in the physical and mental health of the people of England, and

(b)in the prevention, diagnosis and treatment of physical and mental illness.

(2)For that purpose, the Secretary of State must exercise the functions conferred by this Act so as to secure that services are provided in accordance with this Act.

(3)The Secretary of State retains ministerial responsibility to Parliament for the provision of the health service in England.

(4)The services provided as part of the health service in England must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.”


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