The reasons why Matt Hancock’s proposed NHS reforms should worry us all

Matt Hancock NHS
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Government plans to restructure the NHS have been met with criticism from academics and campaigners, as they warn the plans could see increased privatisation and cronyism.

On 5 February, Health Policy Insight published a leaked draft of a white paper outlining plans for an NHS overhaul. The proposals promises to improve integration and remove bureaucracy from the NHS, while giving local authorities more control.

These proposed reforms seem to answer many of the criticisms levelled at the NHS’s current structure, but some have warned the reforms will create more problems.

During a debate on 11 February in the House of Commons, at which Matt Hancock introduced the white paper, shadow health secretary Jonathan Ashworth said:

When the Secretary of State voted for the Cameron reorganisation 10 years ago, it was presumably because he wanted, in the words of the White Paper at the time, “to liberate the NHS”. Now he is proposing a power grab that was never consulted on by the NHS.

The white paper

Currently, only a draft of the white paper is public. According to the draft, the main aim of the reforms is based around “joining up and integrating care around people”. The restructuring will require the NHS to collaborate with local authorities on the boards of ‘integrated care systems’ to decide the use of NHS resources.

The white paper also outlines plans for “reducing bureaucracy” in the NHS. It says that the NHS will be allowed greater flexibility to work together by altering competition and procurement laws made in the 2012 Health and Social Care Act.

Read on...

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Finally, the draft aims to ‘improve accountability’ in the NHS. This notably includes more power for the government over a merged body of the NHS, consisting of NHS England and NHS Improvement. According to Matt Hancock, this change would mean:

the Secretary of State will be empowered to set direction for the NHS and intervene where necessary.

Cameron reforms

Under then prime minister David Cameron, the 2012 Health and Social Care Act introduced a series of reforms to the NHS. Chiefly, this included creating NHS England to manage the health service. It also introduced Clinical Commissioning Groups (CCGs) to control local health care, in the place of primary care trusts.

While the 2012 reforms were a large shake up for the NHS, they maintained the internal market created by the 1990 National Health Service and Community Care Act. The 1990 act split health care into purchasers and providers of care that could compete with each other.

The 2012 act extended market competition by focusing on a “diverse” choice of providers for patients. Since the act came into force, studies have found evidence that a large number of contracts went to private providers.

‘Off-target’ reforms

Writing for the British Medical Journal (BMJ), research associate Peter Roderick and public health professor Allyson M Pollock outlined their problems with the new reforms.

They said the bill would only consolidate the NHS’s internal market, while plans to ‘reduce bureaucracy’ could mean less transparency in competition for contracts. They went on to write that controversial contracts awarded without competition during coronavirus (Covid-19) could become the norm under the new legislation.

Pollock and Roderick highlighted that proposals to set up new boards included no controls over membership, and therefore could be open to private companies. They also said the reforms would give the ministry the ability to bypass parliament.

They further stated:

These proposals are incoherent, de-regulatory, off-target, and badly timed. They will do next to nothing to remedy the serious shortcomings highlighted by the pandemic: a depleted NHS, a privatised social care system, with over-centralised, fragmented and part-privatised communicable disease control and public health systems. Joined-up legislation is needed to revitalise local authorities and to rebuild public services.

Vulnerability to privatisation

The NHS campaign group We Own It has stated its opposition to the restructuring, saying it would leave the NHS even more vulnerable to privatisation than before.

The group criticised the ability the white paper would give for private companies to sit on NHS boards, as well as the provision allowing the government to hand out contracts without competition. It added that the reforms opened the door to privatisation by offering patients more choice from private providers.

Pascale Robinson, campaigns officer at We Own It, told The Canary:

Throughout this pandemic, the government has consistently shown it prioritises the interests of private companies’ profits over public health. That’s why they’ve handed billions of pounds of contracts to their mates in the private sector rather than invested properly in our NHS and local public health teams.

Matt Hancock’s attempts to overhaul the NHS is more of the same. 

He added:

This reckless plan has to be stopped. In its place, we need to reinstate the NHS as a fully public service, with the rampant privatisation currently endemic torn out at its roots.

While any overhaul of the NHS is at a very early stage, restructuring plans currently may remove the ability for scrutiny of contracts, while giving private companies a larger say. The leak of the draft white paper shows we must be ready to fight for our NHS.

Featured image via Wikimedia Commons/SLaMNHSFT & Wikimedia Commons/Richard Townshend

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  • Show Comments
    1. The tories have been dismantling the NHS since the day it was conceived by Nye Bevan the Labour MP.
      They want the US style ‘health for profit’ model… They’ll get it too…..
      Kakistocracy and monarchy continues to decay progressive civilisation…..

    2. The reasons why Matt Hancock’s proposed NHS reforms
      should worry us all.
      WELL voter + N.H.S. staff dose this NOT ring a bell with us
      Did not Mr Hunt under Ms May do the same thing just before he did a runner while running the N.H.S and trashing it as part of stage one Tory party members way of privatising it the Tory party members it had in mind now stage two is coming into force faster now while were are in L-Down WHY?
      Is Tory party trashing our N.H.S fully now before they lose power next G.E. time voter yes, they are we free voter believe.
      So, voter of U.K. Boris + Hancock will keep us in L-Down fully to stop us protesting on our streets about the new rules coming to our N.H.S that will Finnish Tory party members trashing of it fully.
      I wonder what new pay contracts has Hancock got on his little brain to screw our N.H.S staff out of wages cash ??
      Will he Cap N.H.S wages??
      Will he put their wages in private sector trust hands of Hospitals not Tory Govt so private sector can screw then out of increase wages??
      Will he just Not listen to us public + N.H.S staff telling him to bin the new C**p he has in mind for N.H.S. reforms or just do has he likes before he p***s off out of U.K. to work in U.S.A areas with other Tory Minister following him leaving Boris to clean his C**p up and face the raff of us public + N.H.S staff in U.K. areas??

    3. The Tories won’t be happy until they have taken over the NHS and privatised the lot!! Still I’m sure every worker will receive a refund of their NI deductions for the last at least 10 years.

      The biggest problem we face is that the majority of younger healthier people do not realise that it is their future healthcare which is being taken away. It is only those who are unfortunate enough to need the NHS at a younger age, who will notice any difference.

      In those famous words from Joni Mitchell “Don’t it always seem to go. That you don’t know what you’ve got. ‘Till it’s gone. They paved Paradise, put up a parking lot…

      1. well said–Caz
        The young voters coming to vote now in Local area May 2021 election for Cllr need to address this matter with them -Come next G.E .They also need to have words with Govt parties after their votes -that will trash our N.H.S. fully if the young voters lets then do so
        Time to get shut or Labour + Tory parties from power put a new Govt party in place that serves our N.H.S + funds it fully including looks after us voter be us poor or not frailly.

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