Answer: Because it lost control of NHS reform.
Today – or if they donâ€™t get to it on Wednesday – the House of Lords will stage a further debate about stopping the development of the third sector in the NHS.
Long term blog readers will remember that their Lordships debated this issue in November 2011 and that I commented on the issue at the time. In that post I asked if the Department of Health would become the only Government department forbidden by law to develop the capacity of the third sector.
This part of the mess Â that is the Governmentâ€™s NHS reform policy stems from their â€˜Uâ€™-turn last June. Then, in order to persuade the BMA that they were not in favour of greater private sector involvement in the NHS; they said that they would pass legislation,
â€œâ€¦to outlaw any policy to increase the market share of any particular sector of providerâ€
and amended the Bill to that effect.
This does not reflect the policy of any other Department of State. So, for example, the Department for Education or Department of Communities and Local Government can argue that the third sector should be providing more services – for example for young people or environmental services.
But this will be illegal for the National Commissioning Board and the NHS.
And the passing of this law will have an even bigger impact.
We know that NHS bodies are always anxious to avoid breaking the law. This makes it likely that the NHS Commissioning Board – and the NHS in general – will interpret the Health and Social Care Bill as meaning that capacity building – and other policies which support the development of social enterprises and voluntary and community organisations -would become illegal. As a result, it could make it harder for charities and community groups to provide the services and support that many (particularly those who are vulnerable and hard to reach) rely upon.
Which means that the NHS will not only be the only part of Government that cannot have a policy to develop a higher proportion of services through the third sector, but they may also be unable to spend taxpayerâ€™s money on improving the capacity of the third sector to provide health services for NHS patients.
Letâ€™s remember that when this Government published its White Paper in July 2010 it said that it wanted to create in the NHS, â€œthe largest social enterprise sector in the world.â€
The gap between their intentions of July 2010 and the practice of February 2012 is now enormous.
They have reached this state of affairs by trying to change the law to appease the BMAâ€™s anxiety about introducing more competition into the NHS.
It didnâ€™t change the mind of the BMA – it just created a mess.
This is what happens when a Government loses control of its policy on NHS reform.