NHS reforms Health and Social Care Bill

Abstract

After more than a year of debate and numerous last-minute attempts to overturn legislation, the NHS Health and Social Care Bill finally jumped its last hurdle. The Health and Social Care Bill was introduced into Parliament on 19 January 2011. The Bill takes forward Equity and Excellence: Liberating the NHS (Department of Health (DH), 2010a) and the subsequent Government response Liberating the NHS: Legislative Framework and Next Steps (DH, 2010b), which required primary legislation. The Bill, which has had more scrutiny than any other Bill (more than 1000 amendments in its passage through the House of Commons and House of Lords), has now received its royal assent and is enshrined in law. The hardest task of all begins as Andrew Lansley, Secretary of State for Health, spearheads the largest health service reorganization in the history of the NHS. Central to the plans is the radical restructuring of the health service in England, which gives GPs control of much of the NHS’s £106 billion annual budget. The Bill cuts the number of health bodies and introduces more competition into services, all with the aim of reducing administration costs by a third. A summary of the original proposed changes to the NHS from the White Paper was published in February 2011 (Thomas, 2011). In essence, the amendments to the original recommendations fall under several headings, with the main points listed below: Accountability ■The Secretary of State’s duty to promote a comprehensive health service is restored. The Secretary of State will be ultimately accountable for securing the provision of services and this duty will now be exercised through the NHS Commissioning Board and other bodies ■The Secretary of State is now able to intervene only if institutional failures are ‘significant’ ■There are new requirements on the NHS Commissioning Board and clinical commissioning groups to promote the NHS Constitution ■Clinical commissioning groups are now required to have a governing body that must adhere to Nolan Principles (Committee on Standards in Public Life, (2008). Two lay members must be included to champion public and patient involvement and lead on governance ■Governing bodies must meet in public, with minutes of meetings and details of contracts to be published.