Shaking up the England NHS


Shaking up the England NHS

The NHS in England is set for its biggest shake-up in a decade. The aim of the new legislation, proposed in a white paper published last week, is to roll back reforms introduced by the former health secretary Andrew Lansley in 2012. It would scrap the tendering rules, under which public health providers and private companies compete to win contracts to run services from GP-led commissioning groups. Health and social care bodies will instead be encouraged to integrate and pool resources. The plan would also return powers to the centre by giving ministers more control over NHS England, the arm’s-length management body set up in 2012.

Health Secretary Matt Hancock said the plan would cut bureaucracy and allow the NHS to focus on “the health of the population, not just the health of patients”. In response to critics who questioned its timing, he insisted that the Covid pandemic had made reform “more, not less urgent”.

NHS reorganisations tend to come round once a decade, so we were due a shake-up. And this one seems to have more to recommend it than most. The pandemic has highlighted the need for a more joined-up health service: under a more integrated service, for example, the NHS push at the start of the pandemic to discharge elderly patients from hospitals to care homes might never have occurred. But given the strain the NHS is under, this is no time to introduce major reform. It’s the last thing exhausted medics need, The NHS is battling the worst public health crisis in its history; waiting lists for treatments of every sort are alarmingly high. What the system needs right now is more funding, not more disruption.

The crisis has made clear that the 3.4% annual real-term increase in NHS funding promised up to 2023/24 is too meagre, Welcome as some of the reforms in the white paper are, they’ll amount to little if the Government can’t find a way “to plug the multibillion-pound shortfall in social care funding and integrate it with the health system”.