Rhian Vandrill shares her early thoughts on the long-awaited Health and Care Bill.
Yesterday (6 July 2021) the Health and Care Bill 2021-22 was introduced in Parliament. Its publication arrives as the NHS celebrates its 73rd birthday and a new Health and Care Secretary at its helm. So a notable week for the health and care sector.
The Bill is big and bold and runs into 232 pages. It is divided into six parts but perhaps more simply put is a Bill of two parts, with proposals for legislative change focussed on integration and collaboration and, more controversially, new powers for the Secretary of State. It builds on the proposals for reform made in NHS England's Long Term Plan to make the NHS less bureaucratic, more accountable and more integrated, particularly in light of the Covid-19 pandemic.
The Bill aims to ensure that each part of England has an Integrated Care Board and an Integrated Care Partnership responsible for bringing together the NHS and local government to deliver joined-up health and care services and support for its population.
Over the coming weeks our team of integrated health and care lawyers will be unpicking some of the details of the Bill. Ahead of that more detailed analysis, we're sharing our first thoughts.
- the introduction of integrated care systems and details of their statutory duties, including constitution
- abolition of clinical commissioning groups
- Care Quality Commission oversight over how social care is commissioned
- the development of a new procurement regime for the NHS and public health
- new wide ranging powers for the health secretary to intervene in NHS decisions and powers, including local service reconfigurations
- removal of the Competition and Markets Authority's ability to review NHS Foundation trust mergers, with NHS England taking on this responsibility. However, the CMA will continue in its role of regulating competition in the independent health sector.
While the Bill has been broadly welcomed, a number of NHS leaders and think tanks have raised concerns over the new ministerial powers which could risk undermining important reforms.
Nuffield Trust chief executive Nigel Edwards explains that while there is a clear logic to the parts of this Bill that would allow the NHS to collaborate more, he is concerned that “these changes are bundled up with new powers for politicians to control the detail of how the health service runs. The evidence of the past suggests this may lead to worse decisions, and they will come to regret it.”
And on social care reform, Edwards says this Bill does not solve “any of the problems that have brought this sector to a point of crisis, where hundreds of thousands of people needing care cannot get it. It's all very well to hold local councils to account for delivering, but at the moment they are operating within a system that all political parties agree is fundamentally broken.”
As the draft Bill stands, many recognise that it represents the right direction of travel and that these reforms are a critical step in the journey. NHS leaders are working hard to meet the April 2022 deadline when ICSs go live, with chairs of the ICSs needing to be in place by September 2021.
Do get in touch if you'd like to discuss the implications of the ICS clauses in the Bill. Watch out for our series of autumn ICS webinars.
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