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NHS Bill would “do more harm than good”, argues Nuffield Trust chief

NHS Bill would “do more harm than good”, argues Nuffield Trust chief

The National Health Service Bill, to be debated in parliament tomorrow, has been said to risk “doing more harm than good” by an independent health charity
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The National Health Service Bill, to be debated in parliament tomorrow, has been said to risk “doing more harm than good” by an independent health charity.

The Bill proposes to reverse 25 years of marketisation in the NHS, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities, supporters of the Bill explained.

The online campaign for the Bill stated: “Over the last 25 years, this founding vision has been slowly but surely eroded. The final blow was the Health and Social Care Act 2012, forcing a commercialised model on the NHS in England. We believe that campaigning to reinstate the founding vision is critical.”

“Scotland and Wales have already reversed marketization and restored their NHS without massive upheaval. England can too,” the campaigners continued.

However, Nigel Edwards, Nuffield Trust chief executive, has argued that: “The last reorganisation left parts of the NHS system broken, but another one now would risk doing more harm than good. Managers and clinicians are putting enormous effort into piecing things together to create services that work at a local level. I worry that yet another round of abolishing, reforming and creating new administrative bodies would be a distraction.

“The fundamental issue facing our hospitals and GPs is the pressure created by rising patient numbers and need, combined with tight funding. We need to let the NHS get on with dealing with this as best it can. Further interventions from politicians will rarely be the answer,” he added.

Key aims of the Bill:

  • Declare the NHS to be a “non-economic service of general interest” and “a service supplied in the exercise of governmental authority” so asserting the full competence of Parliament and the devolved bodies to legislate for the NHS without being trumped by EU competition law and the World Trade Organization’s General Agreement on Trade in Services.
  • Centralise NHS debts under the Private Finance Initiative (PFI) in the Treasury, require publication of PFI contracts and also require the Treasury to report to Parliament on reducing NHS PFI debts.
  • Abolish Monitor – the regulator of NHS foundation trusts, commercial companies and voluntary organisations – and repeal the competition and core marketization provisions of the Health and Scocial Care Act 2012.
  • Allow local authorities to lead a ‘bottom up’ process with the assistance of clinical commissioning groups (CCGs), NHS trusts, NHS foundation trusts and NHS England to transfer functions to Health Boards.
  • Abolish NHS trusts, NHS foundation trusts and CCGs after the transfer by 1 January 2018.
  • Plan and provide services without contracts through Health Boards, which could cover more than one local authority area if there was local support,
  • Reinstate the government’s duty to provide the key NHS services throughout England, including hospitals, medical and nursing services, primary care, mental health and community services.
  • Integrate health and social care services.
  • Integrate public health services, and the duty to reduce inequalities, into the NHS.
  • Abolish the NHS Commissioning Board (NHS England) and re-establish it as a Special Health Authority with regional committees.
  • Re-establish Community Health Councils to represent the interest of the public in the NHS.
  • Declare the UK’s agreement to the proposed Transatlantic Trade and Investment Partnership and other international treaties affecting the NHS to require the prior approval of Parliament and the devolved legislatures,
  • Require the government to report annually to Parliament on the effect of treaties on the NHS.
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