There’s no disguising that this is a big defeat for those of us who want to see the NHS remain a true public service, run on the basis of patient needs, rather than maximising private shareholder returns.

Government health spokesperson in the Lords Earl Howe was adamant that the regulations did not in effect impose competition on local GP-led commissioning groups. However, it’s very hard to see what other effect the combination of strict definitions and increased legal threats from private health providers would have, other than to force local commissioners to put services out to the market.

Earl Howe promised further guidance for commissioning groups in interpreting the regulations, and we will be watching it closely. But this is unlikely to change anything, as however politely he words them, the guidelines will be trumped in law by the regulations themselves.

We now face the very real risk that local commissioning groups will feel they have no choice but to open services out to competition, against their wishes. Vital NHS funding will be diverted into costly tendering and legal fees, to say nothing of the profits and shareholder returns that private providers will want to extract.

We’ll be watching the government’s new guidelines closely, but the next steps for the campaign will need to be local, working with the broad coalition that has developed over the last year to counter the threat of privatisation and cuts in our health service, to help protect local services where conflicts arise. The TUC will be working more too to shine a light on the world of private healthcare providers, and producing materials and publicity to back up local and national campaigns, where companies are seeking to oust local NHS providers.

The government have taken a big risk in their determination to force through these fundamental changes to our National Health Service, and we believe it is one which will come back to bite them once they have to justify themselves to the voters again. We’ll be doing all we can from now on, to hold them to account over these cavalier and damaging changes.

NB: If you haven’t yet joined us at Going To Work, sign up online and we’ll keep you informed about further NHS and other campaign activities as they come up.

Although the regulations have passed into law already, by a quirk of parliamentary procedure, Peers still have the right to overrule the government, and annul the regulations.

This is going to be difficult to do, as Peers seldom interfere with secondary legislation like this, taking the view that Parliament has already spoken on the issues in the primary legislation and the subsequent regulations are merely putting them into practice. But this is a very unusual case, and Peers would be well within their rights to refuse the regulations. An influential House of Lords Committee criticised the rushed, last-minute way the regulations had been pushed through. They sympathised with the view that they should be withdrawn to allow time to properly consult on and scrutinise new regulations and get them right.

When the original Health and Social Care Bill was being passed in Parliament, there was a huge amount of pressure from the public and medical professions, and the government had to make some major assurances to Peers in order that they might let it pass.

Earl Howe, the government health lead in the Lords, had to promise categorically that local commissioning groups would not be forced into putting services out to competitive markets if they wanted to choose an NHS provider instead. Peers had been especially worried that local people’s views would be overridden by mandatory competition.

Even with these promises, the Bill had a rough ride, surviving rebellions in two crucial votes.

Which made it all the more shocking when the new Health Secretary Jeremy Hunt came back with his regulations to put the approved Act into practice. The new regulations would have required GP commissioners to put virtually all services out to competition, breaking the promises made to the Peers the previous year.

After an uproar, the government rewrote the regulations, softening the language regarding enforced competition, but the issue was far from solved. It’s no longer as baldly stated, but the regulations will still have almost exactly the same effect – meaning commissioning groups feel that they need to put services to private competition.

There are lots of sensible reasons why commissioners might want to stick with an NHS provider who is delivering a good service and in line with local priorities. But under these new rules, unless they can prove that they are the only provider who can deliver that service (not another local hospital, not a private company who might claim they can deliver the service), they will have to go out to competition.

What does this mean for our NHS? It means more fragmentation, more public money diverted into private company profits, and time and money wasted on complicated contracting instead of patient care.

The Lords debate today is such an important chance to reject these damaging rules, that have been pushed through regardless of the earlier wishes of the House of Lords. Peers have already been inundated with messages from concerned members of the public and health workers – Our thanks to everyone who has helped write to them using our Adopt A Peer tool. Peers now need to listen to the concern in the country and kick these regulations out.

A key House of Lords Committee examined the new regulations, after receiving extensive feedback including from more than a thousand Going To Work supporters, and their report (see section C) criticised the rushed, last-minute policy-making process and confusion over what the revised regulations actually meant. The Committee referred them for the ‘special attention’ of the House of Lords, who will now be debating the regulations on 24 April, after Parliament’s Easter recess.

A ‘fatal motion’ has been laid in the Lords against the regulations, and the debate on 24 April still has the power – if supported by enough Liberal Democrat and crossbench Peers – to revoke the regulations and send the government back to the drawing board.

If you didn’t contact a member of the House of Lords yet, using our Adopt A Peer tool, please do. And if you wrote to one already, please consider writing to another too.

Click here to get started

The last few years have seen a drastic erosion of living standards for ordinary families and working people in the UK. Households are being stretched to the limit by a perfect storm of a harsh economic climate, coupled with slashed support and services from the state.

• Real wages are still falling, and prices rising fast. Since 2009 the average worker has ‘lost’ £4,000.
• The welfare spending cap will cut support for low income families both in and out of work. Child benefit freezes and cuts will lose two-child families more than £1,000 by 2015. Tax credit cuts have already lost some families over £2,000.
• The Bedroom Tax will cut housing benefit for 670,000 households. The average household affected will lose over £700 a year, with disabled people and lone parents hit particularly hard.
• Big spending cuts will have slashed the value of public services, such as schools, public transport and hospitals, by £7,000 per household by 2018.
• Centrally-imposed reductions to council funding mean as many as 400 libraries risk closing, as well as other local services from youth centres to playgrounds. Hundreds of Sure Start centres have already gone.
• NHS cuts have seen 6,000 nursing posts lost, and A&E and maternity services, such as Lewisham hospital, are under threat. New marketisation plans will fracture NHS services locally and divert front line service funding into bureaucracy to support competition.

But it doesn’t need to be this way. George Osborne’s 2013 budget represents a chance to break with the self-defeating cycle of austerity, and start to build an economy that works for ordinary families and working people, not just those at the top.

We’re holding a mass rally in Westminster on the evening of 13 March, to put pressure on the Chancellor ahead of his budget. Please join us there to help make the case for Britain’s hard pressed families. If you can’t get to London, you can support and follow the event online.

Find out more, and sign up to get involved now.