Thank you for contacting me about the Health and Care Bill.
I completely agree with you that the unprecedented threat of the COVID-19 pandemic reminded us how vital our health and care system is to all of us. I want to assure you that the NHS will always be free at the point of use, and any proposed reforms will aim to continue to improve the quality of these services and patient outcomes.
As we build back better from this pandemic, it is right and necessary that our health and care services are at the forefront. The pandemic underlined not only the dedication and skill of those in this sector, but also the necessity of a broader, more integrated health and care system. I welcome the intention to develop more joined up, integrated care between the NHS, Local Government and other partners including the voluntary and community sector, which will be vital in tackling the factors that affect the long-term sustainability of patient services. The Bill will make permanent some of the innovations we have seen as a result of the pandemic. I understand that these proposed reforms will also include proper accountability mechanisms, and give patients and the public the confidence that they are receiving the best care from their healthcare system.
The measures set out in the Health and Care Bill deliver on the NHS’s own proposals for reform in its Long Term Plan. These proposals have been developed in consultation with key stakeholders in this sector, and I am encouraged by the preliminary positive feedback received including, in particular, the comments from the Chief Executive of NHS England, who has said that this Bill “will support our health and care services to be more integrated and innovative so the NHS can thrive in the decades to come”, are reassuring.
Government financial support: More broadly, I am pleased at the Government’s clear commitment to supporting the NHS and our wider healthcare system. The Government will provide the NHS with £33.9 billion in funding by 2023/24, which is the largest, longest funding settlement in the history of the NHS, and is confirmed in law by the NHS Funding Act. In addition, the NHS Long Term Plan commits £4.5 billion in primary and community care to help strengthen local healthcare networks.
Integrated Care Systems (ICS) and privatisation: It is irresponsible scaremongering to suggest that ICSs are being used to support privatisation, or cuts to NHS funding. The NHS will always be free at the point of use, and I believe these reforms will continue to improve the quality of NHS services and outcomes for patients. Ensuring every part of England is covered by an ICS is a key way of promoting local collaboration.
ICBs and Private Providers (eg Virgin Care)
Integrated Care Boards are given a range of powers and duties under the Health and Care Bill, and will oversee the local NHS in their area. This will help to improve care and integration between health and social care locally. They are statutory bodies controlled by NHS England. I welcome the ability, set out in the Bill, of local NHS leaders to propose their own constitutions for choosing members of the Boards. This means that Boards could include companies that provide major local NHS services. Boards must also include NHS leaders, GPs, council leaders and independent non-executives. Meetings will be held in public and decisions must be transparent. Any conflicts of interest will have to be declared and managed.
Accountability: The Bill includes proposals to give local people, local clinicians and NHS organisations more control over the way health and care services are delivered. However, in a democracy, the public and Parliament, rightly, expect to be able to hold to account the decision makers who oversee the health system and the performance of the NHS, so I welcome measures in the Bill to allow for this. Importantly, I am assured that individual clinical decisions are explicitly exempt from the scope of the powers for the Secretary of State.
Timing of reform: The reforms set out in the Bill are vital to help our NHS build back better from the COVID-19 pandemic. Those in the system are telling Ministers that they are ready to implement the reforms and there should be no delay, and so, while I appreciate the concerns you have and will bear these in mind, I am satisfied that now is the right time to proceed.
NHS Managers: NHS managers have played a vital role throughout this pandemic. I am pleased that Chris Hopson of NHS Providers, which represents NHS managers, agrees with these reforms that will end the “unnecessarily rigid NHS approach to procurement”. It is also welcome that this White Paper enacts the recommendations of the 2019 Kark Review for stronger measures to ensure that NHS senior managers have the right skills, behaviours and competencies. I understand that there are no plans at this stage to statutorily regulate senior NHS managers and leaders, and I will continue to monitor this closely.
Professional Regulation: The powers sought through this Bill form part of a wider programme aiming to create a more flexible and proportionate professional regulatory framework that is better able to protect patients and the public.
Section 60 of the Health Act 1999 provides powers to make changes to the professional regulatory landscape through secondary legislation. This clause extends the scope of the existing powers in section 60 of the Health Act 1999 regulating health and social care professions by means of Orders in Council to make further changes to the professional regulation system. Section 60 provides powers to amend legislation in relation to nine health and care regulatory bodies which operate across the UK.
These additional powers will widen the scope of section 60 and enable the Secretary of State to make additional changes. The powers will enable the abolition of an individual health and care professional regulatory body where the professions concerned have been deregulated or are being regulated by another body; the removal of a profession from regulation where regulation is no longer required for the protection of the public; the delegation of previously restricted functions to other regulatory bodies through legislation; and the regulation of groups of workers concerned with health and care, whether or not they are generally regarded as a profession i.e. senior managers and leaders.
Secondary legislation made using the new powers would be subject to the existing provision in Schedule 3, namely, a public consultation and the affirmative parliamentary procedure.
Thank you again for taking the time to contact me.
Craig Whittaker MP