The government has just published regulations under Section 75 of the Health and Social Care Act 2012, making it compulsory for the new local commissioning bodies – clinical commissioning groups – to use market mechanisms to commission health services. Liberal Democrat MPs and peers were assured by ministers during the passage of the bill that it did not mean the privatisation of the NHS, and that local people would have the final say in who provided their health services.

The regulations break these promises by requiring virtually all commissioning by commissioning groups to be done through competitive markets, forcing through privatisation. They contain sweeping, statutory powers for the regulator, Monitor, to enforce competition, on their own account or at the request of private companies.

This is an irrevocable change, bringing the NHS into the scope of European competition law, making it prohibitive to remove these "business opportunities" for private companies. And this will not be a managed market, with ministers able to make strategic choices about priorities. It will be a US-style market in health, and austerity will ensure it will be a two-tier service, with a proper service for those who can afford top-up private insurance, and a basic service for the rest of us.

Ministers said:

• "There is absolutely nothing in the bill that promotes or permits the transfer of NHS activities to the private sector." (Andrew Lansley, 13 March 2012, Hansard)

• "I know many of you have read that you will be forced to fragment services, or put them out to tender. This is absolutely not the case. It is a fundamental principle of the bill that you as commissioners – not the secretary of state and not regulators – should decide when and how competition should be used to serve your patients interests." Andrew Lansley, 12 February 2012, Letter to clinical commissioning groups

• "... to avoid any doubt, it is not the government's intention that under (clause 75) that regulations would impose compulsory competitive tendering requirements on commissioners, or for Monitor to have powers to impose such requirements." (Simon Burns, 12 July 2011, Hansard)

• "We intend to make it clear that commissioners will have a full range of options and that they will be under no legal obligation to create new markets …" (Lord Howe, 6 March 2012, Hansard)

But the regulations say different. According to David Lock, QC, they have the effect of closing down the current option of an in-house commissioning process. They sweep all existing arrangements between NHS bodies into a market framework.

Regulation 10 makes whatever Monitor judges to be an "unnecessary" restriction of competition, illegal, effectively closing down the current option of one state body (a commissioning group) making a new arrangement without competition with another (an NHS trust).

Regulations 13-17 give Monitor sweeping statutory powers making it the judge of when a group has breached regulations, to end any arrangements the group has made and to impose their own – including the criteria governing selection of suppliers.

What you can do

These regulations will become law unless they are stopped in parliament. The best opportunity to do that is in the Lords, where there will be a debate and a vote this month. When the bill was going through parliament, Lib Dem MPs and peers believed the assurances and swallowed their doubts for the benefit of good relationships within the coalition. They may have believed their Conservative partners would reciprocate by supporting their priority issue: reform of the House of Lords.

• Lib Dem and cross-bench peers are the only people who can stop this. They can vote to have these regulations annulled. Use your influence to ensure that they understand this.

• The 211 local clinical commissioning groups thought they were going to be in charge, but in future they will be the agents of Monitor. If enough of them expressed their opposition, the government's position would be weakened. Get your local group to wake up.

• Join the 200,000 people who have already signed a petition against these regulations.

This is a last chance to save the NHS we celebrated in the Olympics ceremony. The Mid-Staffordshire trust inquiry report shows that the culture of care has already been damaged by managing the NHS as though it were a market, but it can be repaired and be the safety net we have relied on for 65 years.

Sue Richards is a member of Keep Our NHS Public, a non-party political organisation aiming to retain the NHS as a publicly provided, funded and accountable service.

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