The Health and Social Care Bill was approved by the House of Lords on Monday evening this week. The Bill still needs to be given Royal Assent but this is hoped to be given before Easter.

Since 1948, for over 60 years anyone resident in theUKhas had access to free NHS treatment from antenatal care through to end-of-life care.

The legislation abolishes Strategic Health Authorities and Primary Care Trusts and gives much greater responsibility and control over care budgets and commissioning decisions to GPs and other health professionals, while greater competition with the private sector will be encouraged. This change is intended to reduce administration costs by one third. Opposers believe that the Bill will fragment the NHS and let private providers take over whilst care is rationed.

Shadow Health Secretary Andy Burnham said: “On this day, in the Queen’s Diamond Jubilee year, we should be celebrating what a much-valued social ­institution has done to bind our nation together throughout the 60 years of her reign. Instead, we gather to dismantle it.”

The NHS was launched with 3 core principles to provide healthcare to everyone, for free regardless of wealth but based on clinical need, with a budget of £437 million. Today this has grown to a budget of around £106 billion. Ministers deny they want to privatise the NHS but health leaders fear growing privatisation is inevitable.

With 1.7m employees treating around 3 million people in England every week, it is not surprising that Professional bodies representing doctors (The British Medical Association and Royal College of GPs), nurses (Royal College of Nursing) and other NHS workers have opposed the Bill warning that it will open the doors to mass privatisation of services and have joined opposition politicians in fighting the changes which are proposed by the Health and Social Care Bill.  The opposition is based on fear that this will lead to a compromise on quality of care as new providers of services win contracts with unrealistic low bids, leaving patients dissatisfied with their treatment and care.

This also raises the important question of whether quality of care can be maintained during these changes and how this will impact on patient care where services are under competition between hospitals and other providers.  Although the Bill focuses on improving patient treatment and prevention of ill-health many doctors, nurses and other healthcare professionals are concerned with how the new structure and systems will achieve this.