Proposed amendment to Failure Regime - a huge step to re-centralising power?

As readers will know, the Secretary of State has now lost two court hearings regarding the future of A&E and maternity service at Lewisham Hospital. The Trust Special Administrator appointed to neighbouring South London NHS Trust wished to downgrade some of Lewisham Hospital's services. Both the High Court and the Court of Appeal have confirmed that the relevant provisions of the NHS Act 2006 do not permit him to do so. The government regards this as an unsustainable position and has made it clear that it intends to reform the law to allow a TSA appointed to a failed Trust to require changes at another, perfectly successful and stable Trust.

The Care Bill that is currently going through Parliament is the vehicle for these amendments. There are several changes proposed to the TSA regime. The first unsurprisingly makes it clear that a TSA can take action in relation to a neighbouring Trust which is necessary for and consequential on action taken in respect of the Trust to which the TSA has been appointed. Readers will recall that the day after the TSA was appointed to South London the government stated in terms that the TSA regime was not a back-door approach to reconfiguration. It will be very difficult for the government to argue that now.

In other proposed changes the TSA is now given 65 days rather than 45 to produce his draft report on action that should be taken to address the failures he has been sent to tackle. The consultation period that follows will be 40 days not 30. There is a requirement that where a TSA is recommending changes to another Trust and proposed to vary his draft report he must consult with commissioners of that other Trust as well as those of the Trust to which he has been appointed. However there is no requirement for a full public consultation. Nor is there a requirement for commissioner support from the CCG of the affected neighbouring Trust.

If the bill becomes law in its present form the stage is set for reconfigurations to be imposed in very controversial circumstances just as the political class gears up for a general election...

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