March 19 marked the tenth anniversary of the criminal invasion of Iraq, orchestrated and led by Anglo-American imperialism together with its allies.

The illegal invasion, which led to the deaths of nearly 5,000 US and British troops, is thought to have resulted in the deaths of between 150,000 and 1.4 million Iraqi civilians. Such is the magnitude of the crime that there is no universally agreed figure. This week another sixty people were murdered in Baghdad by those whose presence was unknown in the country before 2003, those whom the Anglo-American alliance claimed would be eliminated by the illegal invasion. Such criminal acts highlight the fact that now, as one well-known commentator has expressed it, “Life is less secure, life is less prosperous and basic services still haven't returned to the level they were pre-war.”

On the tenth anniversary there have been many condemnations of the criminal invasion, which was illegal under international law and a breach of the UN charter. However, those war criminals responsible have not been brought to account. Indeed, on the eve of the anniversary Tony Blair was given a public platform by the BBC to present further justifications for the war crimes of his Labour government in Iraq, as well as the opportunity to seek to justify new crimes against the peace in Syria and elsewhere.

The governments of Blair sought to justify military intervention carried out for geo-political advantage or simply for revenge by a variety of means. They revived the methods of the Nazis and developed state-led disinformation and with their major allies engaged in the bullying and manipulation of international bodies such as the UN. In addition they concocted a plethora of bogus theories including “humanitarian intervention”, the so-called right to protect, the notion of “failed” and “fragile” states, as well as operating on the basis that “might is right”, and openly demanding regime change to suit their aims and interests.

However, it cannot be said that the present coalition government in Britain is any less pro-war than its predecessors. It carried out the criminal invasion of Libya, for example, as well as participating in the more recent intervention in Mali. It continues to threaten and bully Iran and the Democratic People’s Republic of Korea and has created the conditions for the current bloodshed and instability in Syria.

In Syria it is further developing the model established in Libya, instigating civil war, shedding crocodile tears about civilian casualties and arming those who will aid it to effect regime change, whatever their character and antecedents. It is has already recognised the opposition to the Syrian government but it is also, as Cameron puts it, trying to “shape” it, in order to strengthen those most favourable to the interests represented by the coalition government of Britain. At the present time, the government is working night and day, alongside the government of France, to find ways to remove EU arms sanctions so that it can arm directly those who it has already been arming indirectly. In short, it is interfering in the internal affairs of a sovereign country, which is contrary to international law and the Charter of the UN.

In regard to the DPRK, the government has been at the forefront of attempts to bully the government of that country and to impose sanctions. This week it has instigated an investigation by the UN Human Rights Council into alleged human rights abuses in the DPRK. In January it played a leading role in drafting the UN Security Council Resolution condemning the launch of a satellite by the DPRK last December and was a co-sponsor of the UNSC Resolution in February, which imposed further sanctions on the DPRK for conducting a third nuclear test. To place these events in some context there have been around 2000 nuclear tests in the last sixty years and around 9000 satellite launches, most of these conducted by the US, but none have resulted in UN sanctions. The continued division of the Korean peninsular and occupation of the South by the US army are just part of the many provocations launched against the DPRK and carried out under the auspices of the UN in which the British plays a leading role. Since a state of war still exists on the Korean peninsular and since the DPRK has recently declared the terms of the 1953 armistice agreement to be null and void, a very dangerous situation has been created, for which the government of Britain must be condemned and held to account.

The last ten years, and the many warmongering and criminal acts committed, have led to many demands for an end to pro-war governments and indeed for an alternative to the political system which continually produces a pro-war Westminster-consensus amongst all the big parties. It must now be the task of the entire anti-war movement, the workers and all democratic people to organise to stay the hands of the warmongers, to bring all the war criminals to justice and usher in an anti-war government.

"Born in Lewisham" protest on March 16, organised
by the "Save Lewisham Hospital" campaignOn Tuesday, thousands of health workers and broad sections of the people are preparing to take part in a lobby of Parliament to stop the passing of the new section 75 regulations of the Health and Social Care Act 2012 and to demand: No to Privatisation of the NHS. Over the last three weeks, following opposition from all over the country, the government was pushed into re-writing the regulations. But it is in essence a re-packaging of the same programme based on the fetish of competition and privatisation. As organisers of the lobby are saying, it is essential that the Clinical Commissioning Groups (CCGs) – which from April 1 will have the role of “commissioning” health care from the “providers” (hospital trusts, or “independent providers”) – “are not forced to use competition, but can decide for themselves whether they use NHS services or whether they choose to use private providers like Virgin or other international companies”.

It must be emphasised that the fundamental issue at stake is that of defending the NHS as a public service that meets the needs of all to health care, as is fighting for the alternative to the dictate of the big corporations over governance and society, on health as on all other vital questions that face the people. Repealing the Health and Social Care Act 2012 along with the regulations 75 is an essential demand of the people to safeguard the future of the NHS in England and Wales. It is a starting point in which the people are fighting for the alternative. That alternative is that the health care system is not a competitive market but is part of the social relations of society to meet the needs of society as a whole. Society makes plans to look after the social and health care needs of everyone resident in the country regardless of their individual circumstances. This is the modern arrangement. The imposition of the market in health care and the interests of the private corporate interests is a throw back to the last century and before, and is an anachronism that causes great harm to society and to those social relations. Society can only make proper decisions by limiting and revoking the influence of the big corporations and their narrow interests over government and society and instead invoke the involvement and interests of health workers and all in society to guarantee the peoples right to health care.

The present direction is to one that gears society to the rich, with its Westminster consensus of the big parties, and serves the interests of the big corporations and financial oligarchy that stand at the heart of the wrecking of the NHS today. It is now nearly a quarter of a century since the Thatcher government introduced its White Paper Working for Patients which introduced to the NHS the idea of an internal market in the NHS which was first imposed between 1991 and 1997. This marked a new stage in the anti-social offensive to tear up the post-war social contract agreed between the big corporations, big government and big labour at that time to have a free universal public social and health care system paid for out of taxation¹. That it has taken them 25 years shows not the strength of the ruling elite but that they are faced with the collective will and social consciousness of health workers and the broad masses of the people who oppose them and have stood every day to block their plans and fight to set an alternative direction for the NHS.

The 2010 imposed arrangement of a Coalition government was given no mandate from the election to carry on this anti-social direction for the health service. The government has operated under the fraudulent cover of imposing austerity to satisfy the impatience of the corporate monopolies to impose savage cuts and attack the social relations of their publicly provided NHS. This is what is behind the take over of the NHS and the grenade that the government has thrown into the NHS in the shape of Health and Social Care Act 2012 and the new section 75 regulations. WWIE hails the growing resistance of the health workers, in Lewisham and all over London and elsewhere to rise to the challenge to block the plans of the government to privatise the NHS and decimate its services and to fight for a change of the direction for the interests of all.

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The Save Lewisham Hospital Campaign (SLHC) has called on all its supporters to join the Lobby of Parliament on Tuesday, March 26, to prevent the government’s attempts to pass section 75 of its Health and Social Care Act.

The Chair of the SLHC Louise Irvine said in the call: “For the last month the Government have been trying to sneak through regulations (the fine details) to the Health and Social Care Act that will mean the privatisation of the NHS. Despite giving repeated assurances they would not do this the drive for profit is greater than their commitment to promises made to us, the electorate. They were caught red-handed and after an amazing groundswell of opposition from all over the country the Government were pushed into re-writing the regulations. A small victory for us, but they are now back with the same wrecking ideas spruced up, cowardly repackaged and due toƒcome in to force on April 1.

“We are calling on all who support the NHS to join us at the Lobby of Parliament (26 March) to urge the Lords and Commons to reject the regulations and to defend the NHS as a public service.”

The amended version of section 75 is another example of the government’s attempts to defuse the opposition to the government’s intentions for the NHS. This was also the case when Jeremy Hunt made the deceptive announcement that the closure of Lewisham Hospital’s A&E Department would be reviewed, while leaving unsaid the reality that an A&E Department cannot function if the hospital services are disintegrated.

See website: http://www.savelewishamhospital.com

The Health and Social Care Act (HSCA) legislates to abolish the NHS Primary Care Trusts (PCTs) and Strategic Health Authorities with health care funds being transferred from the abolished PCTs to Clinical Commissioning Groups partly run by GPs. The British Medical Association has said: "Forcing commissioners of care to tender contracts to any willing provider, including ... commercial companies, could destabilise local health economies and fragment care for patients. Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services."

Kieran Walshe, professor of health policy and management and Chris Ham, chief executive of the King's Fund, argued: "At a national level, it is difficult to see who, if anyone, will be in charge of the NHS. There will be five key national bodies: the Department of Health, the National Institute for Health and Clinical Excellence, the Care Quality Commission, the NHS Commissioning Board, and the economic regulator Monitor. Although the remit of each is set out in legislation, it is not clear how these national bodies will interact or how they will provide coordinated and consistent governance of the NHS.”

The False Economy Blog pointed out: “Section 75 of the Act uses the horrible double negative that the NHS Commissioning Board and Clinical Commissioning Groups must commission services in a way that does ‘not engage in anti-competitive behaviour.’

“In other words, services must be opened up to competition.

“Crucially, the Act says that is up to ‘regulations’ (that is secondary legislation via statutory instruments) to define how the ‘anti-competitive behaviour’ would be prevented.

“The Explanatory Note to the Act says that ‘these regulations will enshrine a full range of options for commissioners, including the ability to secure services without competition, where this would be in patients’ interests’.

“However, the regulations, provided through Statutory Instrument 257 do no such thing.

“These regulations are a blunt tool: they do not provide a ‘full range of options’ to avoid competition.

“Quite the opposite – the only exceptions to competition were for technical reasons (with no definition of what that means), for the protection of exclusive rights (i.e. protecting those all important patents), or in cases of extreme urgency.

“This is a very narrow range of exceptions. For all other services competitive markets must be used.

“The regulations say that any company who wishes to complain how a tender was carried out could avoid the expensive route of going to court and go straight to the judge and jury of Monitor, the regulator, which is given the power to prevent ‘anti-competitive behaviour’.

“In other words, the result of any complaint is likely to be a foregone conclusion: if you complain about a lack of competition, the ‘anti-competitive behaviour’-busting Monitor will intervene. The regulations gave Monitor extensive powers to intervene allowing them to change contracts, change providers and even determining compensation.

“Further, Monitor didn’t even have to wait for someone to complain – the regulations gave them the power to instigate investigations. That is, the all powerful

Monitor could instigate the investigation, perform the investigation, adjudicate and then impose Draconian sanctions on commissioners.

“It is no wonder that a wide range of bodies, including the BMA, the Academy of Royal Medical Colleges and NHS Clinical Commissioners objected to these regulations.

“The size of the objections has forced the government to withdraw the regulations ‘for rewording’.

“However, section 75 of the Act still remains. The government have not said that the regulations were wrong, they have simply said that the wording had ‘inadvertently created confusion and generated significant concerns’ which means that when we get the new regulations we will get more of the same, just worded differently. Civil servants are now stretching for their well-thumbed thesauruses.

“The fight against section 75 is not over, this is just the first round. The regulations caught off-guard a wide range of influential people, and for the next round the government will be more careful.

“The new regulations will say the same as the original one, but the government will use the time to redraft the regulations to talk to those influential people and no doubt offer incentives and assurances.

“This makes it even more important that the public mobilises.

“When the regulations first appeared, it became clear that one route to complain about them was to write to the clerk of the Lords’ scrutiny committee. Normally the clerk receives no more than ten such objections to a statutory instrument, but within a few days the clerk received over 1,500 objections to the section 75 regulations.”

David Lock QC pointed out: "There does not appear to me to be anything substantial in the new Regulations which responds to these very real concerns. The assurances given by Ministers in Parliament about the freedoms that commissioners would have to commission services in the way they consider best for their local populations...do not appear to be honoured by these new Regulations just as they were not honoured by the old Regulations...[if] the contract is capable of being delivered by more than one provider, the CCG must hold a competition even if it is not in the interests of patients to do so...the introduction of wording about integration and co-operation between proxiders does not amount to any substantial change to the effect of the Remulations."

David Worskett, chief executive of the NHS Partners Network which represents independent sector providers, told the Health Service Journal that “some would see it as a victory” although “in the real world” the amendments just make clearer what the government said all along.

“I am sure some doctors will try and adopt a preferred provider policy and some will want to tender and we will see what happens. The regulator will have rather more teeth than they did.”

“But in law the government has made it much, much clearer that it is the status quo that is being enacted.”

The British Medical Association welcomed the redrafting of the rules but chair of BMA Council Mark Porter said he still had misgivings about the “direction of travel for the NHS”.

“The redrafted regulations, if supported by clear guidance, should provide greater clarity on the commissioning process,” Dr Porter said.

“However, we remain concerned about the overall direction of travel for the NHS. It is vital that competition is not allowed to undermine integration, innovation, or clinical autonomy. There still needs to be a full parliamentary debate, to provide absolute clarity that CCGs will have the freedom to decide how best to secure high quality services for local populations.”

Section 5 of the original draft said commissioners could award contracts without competition when they were “satisfied” there was only one provider capable of providing the services, but that this could only be the case for “technical reasons” or “reasons of extreme urgency”. Lawyers had told HSJ the narrowness of the exemptions would make it difficult not to tender significant amounts of NHS work.

The clause restricting when a service can be defined as “capable of being provided by a single provider” has been deleted from the new draft.

In another change, the amended regulations specify that healthcare sector regulator Monitor cannot order a clinical commissioning group to run a competitive tender for a contract.

The regulations still say commissioners “must not engage in anti-competitive behaviour”. However, where previously they prohibited anti-competitive behaviour which was “not necessary for the attainment of intended outcomes which are beneficial for people who use such services”, they now prohibit anti-competitive behaviour unless it “is in the interests of people who use health care services for the purposes of the NHS”.

These interests could be served by “services being provided in an integrated way (including with other health care services, health-related services, or social care services); or by co-operation between the persons who provide the services in order to improve the quality of the services,” the amended regulations state.

(source: Health Service Journal)