The Health & Care Bill. What does it entail?
Back in 2012, Prime Minister David Cameron introduced reforms for the NHS which at the time gave GPs more commissioning powers, increased competition in the NHS and abolished primary care trusts. This was met with wide-spread criticism, with Labour calling the plans “botched”, but now as The Mirror has reported: “The Tories unveil plans to unpick their own disastrous NHS reforms.” What has changed you may ask?
According to the official White Paper, the reforms have been under consideration since January 2019 and within that same month, the NHS created its Long Term Plan which set out its priorities for the next ten years. Health Secretary Matt Hancock has reported these reforms have been developed in partnership with those who know the NHS best. As the White Paper details, “frontline health and social care staff, patients and their families and other experts - suggested targeted legislative proposals that would help to support the implementation of the objectives described in the Long-Term Plan." This is a change in tone from a Conservative government of 2012, who introduced reforms without much consultation from our health and care services.
The new legislation, The Health & Care Bill, has introduced three key proposals for change in the NHS with more powers, such as budget allocation, being transferred to localised areas rather than sourcing from central government. Those proposals for legislation include working together and supporting integration between our health and care services, reducing bureaucracy within the NHS and enhancing public confidence and accountability. Labour questioned the timing of the changes "in the middle of the biggest public health crisis our NHS has ever faced", saying staff were exhausted, as The BBC reported.
However, Mr Hancock has said there was “no better time than now” for these reforms to be introduced. Other countries around the world have adopted new methods during the pandemic to transform their healthcare systems, such as integrating telehealth systems, and the UK is no different. As the White Paper cites, “The response to Covid-19 - led by those who know best - has shown us new ways to deliver care using innovative and creative solutions, exploiting the potential of digital and data, instead of needless bureaucracy.”
This is a major shift in focus, with the government adopting a “population health” approach for how we will deliver health and care in years to come, so we decided to ask some of our partners what they thought of the new proposals....
Vic Rayner, Executive Director at the National Care Forum:
“There are some things that are to be welcomed in the white paper including the greater assurance of local authorities meeting their statutory adult social care responsibilities, recognition of the power and importance of data and mechanisms to address some of the current shortfalls of distributing additional finances directly to the front line.
What this paper is not, is the reform of social care that we have been talking about, and waiting for many years. It is not the plan to ‘fix social care’ or the plan that is ‘oven baked’ and ready to go. The plan we are all waiting for, has once again been drop kicked over the date line – landing at some unknown point ‘later in the year.’
What we need now, not later, is something that is ambitious for social care. Ambitious for people who receive social care, ambitious for people who work in it and ambitious for the communities that they are at the heart of. We are ambitious for social care – and the government must catch up.”
Professor Martin Green OBE, Chief Executive of Care England, says:
“The publication of the NHS White Paper is an opportunity to recognise the interrelationship between health and social care and craft a long term vision for both sectors. Care England looks forward to working with the Government to develop this vision”.
“The current situation where health and social care sit in distinct silos is not good for citizens, and is certainly not making the best of the resources available. We hope that these reforms will reshape the NHS and move us towards a system that is measured by the outcomes and which has a seamless interface between health and social care. Care England would therefore like to engage with the development and implementation of the White Paper. For, if anything, the COVID-19 pandemic has demonstrated the need for the adult social care sector’s voice to be heard in the development of future health and care systems”.
It would seem the proposals have been welcomed but many are sceptical of how the reforms will be implemented, why they were not introduced earlier and why social care and medical practices were not integrated sooner. These reforms should create a path for the integration of health systems within social care, but it will be many months yet before we see the effects.