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‘Controversial’ Health and Care Bill interferes with day-to-day management of NHS


By Jess Hacker
8 July 2021

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Reforms laid out in the new Health and Care Bill risk being undermined by Government interference in the day-to-day management of the NHS, think tanks have said.

The Bill – which was introduced to Parliament yesterday (6 July) – had outlined a number of proposals requested by the NHS itself, in addition to ‘controversial’ new powers for the Health Secretary.

The new powers would enable the Secretary of State to intervene much earlier in instances when local services are being reconfigured, such as the closure of a given unit.

Currently, they are only able to intervene in these cases with the approval of a local authority.

The Health Foundation called for the new Health Secretary Sajid Javid to drop the proposals, which it said ‘is politically driven, has no clear rationale and risks taking health care backwards’.

It added: ‘To ease the Bill’s passing, the new Secretary of State for Health should now drop the contentious proposals to give his role more power over the day-to-day running of the NHS.’

Mr Javid should instead add ‘simple but much needed’ provisions to improve workforce planning across the sector, covering for staff shortages which may slow efforts to tackle the care backlog.

Meanwhile, The King’s Fund stated that important reforms risk being ‘undermined by controversial plans for greater ministerial interference’.

It added that the ministers’ ‘broad powers’ would risk creating a situation where politics trumps clinical judgement.

Wrong time to reform

The BMA raised concerns as to ‘whether now is the right time’ to introduce wholesale reforms, given that the NHS is currently facing its largest backlog on record, with 5.1 million people waiting to receive elective care.

It said that the ‘historic’ workforce crises present before the pandemic has ‘only worsened as those staff have become exhausted’, with a growing number of members planning to leave the health service.

‘Crucially, this legislation must be used as a key opportunity to boost the NHS workforce and strengthen accountability for the delivery of adequate numbers of staff,’ it said, adding that this was ‘instrumental’ to supporting the NHS’ pandemic recovery.

Recently, practice managers were urged to ‘spot the triggers’ that could prompt a GP to leave their practice, after the latest workforce figures showed only marginal increases in primary care staff.

The Bill

The new Bill is also set to introduce a series of measures which the Government says will reduce bureaucracy in the NHS.

Particularly significant was the white paper’s plan for integrated care systems (ICSs) to take over the functions of Clinical Commissioning Groups (CCGs).

Other proposed steps included assigning the NHS and local authorities a ‘duty to collaborate’ and scrapping section 75 of the Health and Social Care Act 2012 which mandated for all NHS contracts to be put out to competitive tender.

Sir Simon Stevens, NHS chief executive, said yesterday that the Bill contains ‘widely supported proposals for integrated care’, which had been consulted on within the NHS.

He added that ‘they go with the grain of what our staff and patients can see is needed, by removing outdated and bureaucratic legal barriers to joined-up working between GPs, hospitals, and community services’.

The white paper has previously come under criticism for its lack of clarity around primary care’s involvement in ICSs.

In May, a survey revealed that half of primary care managers said they were ‘unclear’ or ‘very unclear’ about the role of primary care networks (PCNs) within ICSs.

This article first appeared on our sister title, Management in Practice.

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