The Government’s new NHS Care Bill aims to remove care as a consideration, and give Jeremy Hunt’s Special Administrators lawless power to act as any other organisation that used the letters SA. Sturm Abteilung, for example.

Special Administrators (SAs) were an opportunistic creation of Andrew Lansley once the Conservative scheme to render NHS Trusts bankrupt was beginning to bear fruit. They were hastily formed in June 2012, and Hunt was appointed Health Secretary, against everyone’s expectations, in September. But is is Jeremy Hunt who ensured that these Stürmers not only neutered every existing body designed to protect patient care, but were also beyond accountable control – elected or otherwise.

The writing was on the wall anyway with the passing of the controversial Health and Social Act 2012. This abrogated the Government’s existing responsibility, written in Law since 1948, ‘to provide or secure a comprehensive health service. The existing strategic health authorities and primary care trusts left struggling to fullfil that promise after five decades of muddled bureaucracy, were abolished. Once Hunt took over, however, anything in the way of a check to restrain the fanatical zealots of neoliberal accountancy found themselves denuded of power.

* The local authority overview and scrutiny committees that normally manage reconfiguration under normal circumstances retained a non-mandatory role in formulating proposals under the SA process – ie, they could be (and are) ignored as a matter of routine.

* The National Clinical Advisory Team, set up in 2008 to ensure that service change proposals were “safe and accessible for patients” was given no role at all in it.

And while these essentially patient-facing bodies had their cojones chopped off, the SAs were given new powers to ride roughshod over any qualitative consideration:

* The consultation period for special administrators was reduced so that proposals could be drafted, consulted upon, and implemented within a very short timescale.

* Atonishingly, assessment of healthcare needs is nowhere explicitly required in SA judgements. Indeed, no guidance at all has been issued for the administration regime in that respect…because of course, Berkeley-Hunt isn’t interested in any.

Observe how this has worked against health provision since it came in:

* The recommendations in south east London included specified reductions in beds and staffing in three other acute trusts as well as in the South London Healthcare Trust. These were based on assumptions about substantial transfers of patient activity from the acute sector to community settings…and without any plan as to how that transfer would take place.Hold that thought: it gets worse.

In July 2012  the South London Healthcare Trust found itself the unwilling owner of the first SA regime. It provided for SAs to take over the running of trusts and to reconfigure services at will. They recommended closing the emergency department, as well as closing the maternity unit at nearby Lewisham Hospital…which is part of a different trust. Local GP commissioners opposed the plan on the grounds that administrators did not have a legal power to recommend area-wide service changes and the government did not have power to accept them.The High Court ruled in favour of the complainants….Camerlot appealed, and in October 2013 the Court of Appeal upheld the original judgment. Victory! Er, no.

* In Mid-Staffordshire – an area of admittedly appalling mismanagement and gratuitous patient neglect,  the SAs wanted to suggest reductions in beds across several already acute trusts – and transfers of patient activity “into the community” hahahahahaaa. However, the Lewisham victory for decency was in the way:  the Mid Staffs special administrators recognised that “actions across the local health economy were essential” but they did “not have the power to recommend these actions.” It remains unclear why they thought sh*t healthcare could be improved by getting rid of healthcare completely, but let’s not be sidetracked: Jeremy *unt isn’t keep on being opposed.

But Jezzer is getting round the problem….comme d’habitude, under the radar. The government has proposed an amendment to the Care Bill currently going through Parliament that would give special administrators the power to reconfigure neighbouring trusts and services “where necessary for any consequential action taken in relation to” the Trust they’re busy destroying working on.

This is a corker up there with any Emergency Powers Act from the Bolsheviks via the Nazis to Mugabe: there’s a Trust next door doing perfectly well, so we reserve the unassailable legal right to drag it too into the mire.

This really isn’t pluralist, democratic legislation: it is dictatorship by stealth. But then – as last night’s Slogpost sought to evidence – such a stealthy, illiberal focus has become the signature modus operandum of every government from Washington via Madrid and Athens to Paris.

The financial position of NHS trusts has been worsening since 2009-10. The BMJ says that ‘the position will worsen further if NHS England moves £2bn from acute budgets to out of hospital care, as it currently proposes.’

This is exactly what the new Care Bill proposes. But more to the point, it also wants to give the SAs untrammeled powers to pull that kind of stunt of the Hunt in the point without any legislator say in the matter whatsoever.

From the nibbles of a million sticklebacks do liberal democracies die.

The full humorous horror of the stunts of the Hunt in the punt can be viewed at Hunt Balls