Concerns remain over centralised ministerial power in Government’s health and care bill

By - Integrated Care Journal

Concerns remain over centralised ministerial power in Government’s health and care bill

Stakeholders and experts across the health and care sector are still broadly in favour of the Government’s health and care bill, but concerns remain around the over-centralisation of ministerial power.

The bill, introduced to Parliament today by new Health and Care Secretary Sajid Javid MP, represents the largest shakeup of the health service since the Lansley reforms a decade ago.

Key measures of the bill include:

  • Statutory footing for integrated care systems to move services “out of hospitals and into the community”;
  • the development of a new healthcare procurement regime;
  • a package of measures to address some “specific needs” in social care to “improve oversight and accountability” in social care and enhance person-centred models of care with a data led approach; and
  • support for the introduction of new requirements about calorie labelling on food and drink packaging.

While outlining broad support for the bill, Matthew Taylor, Chief Executive of the NHS Confederation, expressed concern at some of its proposals. “Some of the proposals are not what the health service wants to see,” he said, “in particular those that could lead to significant centralised and ministerial involvement in everyday matters that affect the NHS. ”

“In their current form, these plans also bring with them the risk that arm’s-length bodies, including NHS England and NHS Improvement, could be split up or abolished without any real scrutiny. ”

Rachel Harrison, GMB National Officer, criticised the Government for what she deemed as a “power grab”. She said, “The new Secretary of State seems to think giving himself more powers to private companies is more important than putting money in the pockets of those that got us through the pandemic. ” 

Specifically, there are concerns over granting ministers increased powers over appointing chairs of local care boards. Nigel Edwards, Chief Executive of the Nuffield Trust, warned that this would lead to “political figures” being placed in charge of service delivery.

“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,” said Edwards, “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. ”

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