Plans to unpick disastrous Tory NHS reforms will be unveiled today.
A decade after David Cameron’s government fragmented healthcare in Britain and opened it up to the market, a white paper will be published to reverse some of the changes.
Former health secretary Andrew Lansley brought in reforms blamed for encouraging “competition” between health bodies from hospital trusts to GP surgeries, when buying in private healthcare services.
Integrated Care Systems (ICSs) will now be set up to encourage cooperation between the NHS and local councils for the overall benefit of the local population.
However campaigners say the White Paper – which was leaked at the weekend – does not go far enough and many of the Lansley reforms remain in place.
Health and Social Care Secretary Matt Hancock said: “The NHS and local government have long been calling for better integration and less burdensome bureaucracy, and this virus has made clear the time for change is now.
“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population.”
Privately many NHS leaders and some Conservative politicians believe the Lansley reforms to be one of the worst structural revamps in the history of the NHS.
They coincided with record low annual NHS funding increases at the height of the Tory austerity agenda.
Keep Our NHS Public says only part of the 2012 Health and Social Care Act is being repealed.
The White Paper leaves the crucial division between NHS commissioners holding the budgets and providers delivering the care to patients.
Secretary Dr John Lister said: “We have another massive top-down reorganisation which retains the fragmentation and chaos of outsourcing, but threatens to strip away the ‘bureaucracy’ of competitive tendering.
“This leaves huge contracts to be allocated without any competition or accountability – as we have seen in the disastrous cronyism and shambles of the Covid contracts for PPE and test and trace.
“This half-way house will leave the systems fragmented once again, this time under the stolen flag of ‘integration’.
“No reorganisation in itself can compensate for a decade of effectively frozen real-terms funding in the NHS, the massive backlog bill for hospital maintenance and the staff shortages.”
The new plans would grant the Health and Social Care Secretary more operational powers over the NHS.
The Lansley reforms gave powers over the day-to-day running to NHS England and devolved governments in Scotland, Wales and Northern Ireland.
Richard Murray, chief executive of the King’s Fund thinktank, said: “Most important in these proposals is the welcome shift away from the old legislative focus on competition between healthcare organisations.
“The independence given to NHS England is seen as one of the successes of past reforms, and whilst it is right to clarify who is accountable for the health service, Government should protect the day-to-day clinical and operational independence of the NHS.”
Nigel Edwards, chief executive of the Nuffield Trust thinktank, said: “Ministers may come to regret all the new powers they are set to be granted over hospital closures and downgrades… centralising power means you centralise blame, and create more pressure to interfere.”
Shadow Health Secretary Jon Ashworth said: “ Boris Johnson must explain why a reorganisation in the midst of the biggest crisis the NHS has ever faced is his pressing priority.
“With 192,000 patients now waiting over a year for treatment, our cancer survival rates shamefully low by European standards and mental health services stretched to the limits, ministers need to outline how an NHS reorganisation at this point in time will deliver the standards of care patients deserve.”
Edel Harris, Chief Executive of the learning disability charity Mencap, said: “There are huge benefits to further integration between the NHS and the provision of social care.
“However, this reform will backfire unless the crisis in social care is addressed now. Social care has been treated as the poor relation to the healthcare system for too long, and it needs to be placed on an equal footing before we embark on any reform.”
Fiona Carragher, Director of Research and Influencing at Alzheimer’s Society said: “It is essential this is done in conjunction with long term social care reform – as Sir Simon Stevens has said, the future success of the NHS depends on urgently addressing the state of social care.”