THE SECOND READING of the Health and Care Bill will take place on Wednesday 14 July 2021.

Following the first reading on 6 July, the Nuffield Trust Chief Executive, Nigel Edwards, made the following statement:

“There is a clear logic to the parts of this Bill that would allow the NHS to collaborate more, as it has been trying to do for years in the face of the unhelpful 2012 Health and Social Care Act. But unfortunately 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.

“Politicians should have the power to tell the NHS what to do, but they are not best placed to tell it exactly how to do it. The new role for the Secretary of State in intervening at any stage of changes to any service is a recipe for local decisions ending up in Whitehall and Westminster. It risks gridlock and a lack of innovation, and ministers themselves might come to feel it as a millstone around their necks.

“I worry that powers over appointing the Chairs of local care boards might lead to political figures being put in charge of services. They are unlikely to be the best leaders, and some might push local services to achieve political goals for whichever party is in power, instead of quietly serving the interests of patients.

“The local reforms creating Integrated Care Boards do reflect a need for different parts of the NHS to work together. This fits with what services have been doing already across England – a big improvement on the traditional reform approach of dropping clever ideas from Whitehall onto the NHS from a great height.

“However, they too need to be carefully scrutinised by MPs. These changes come as the service is trying to recover from the most unusual and difficult time in its history, and loading too many powers and duties onto new organisations could overwhelm them. Weakening the system of free-standing NHS trusts might help cooperation, but it could also mean hospitals are no longer rewarded for being more efficient, and there is a risk of cosy local monopolies whom nobody holds to account.

“The social care reforms in this Bill do 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. The hope that the NHS will cooperate more with social care services will also come to nothing without proper reform so that more people receive help, more staff join the sector, and stability is restored after years of desperation.”

* The Health and Care Bill, with explanatory notes and briefing papers, can be read here.

* Source: The Nuffield Trust

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