Reforms will bring NHS and social care closer together – Hancock

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Reforms to the NHS which sweep away much of the framework set in place under David Cameron will see the health service and partners work more closely, Health Secretary Matt Hancock has said.

The White Paper, which will be published later on Thursday, brings together the NHS, social care and local government to make decisions with the aim of providing integrated care.

The proposals see a tendering rule scrapped, which officials say has created unnecessary competition and made it difficult for councils and different parts of the NHS to set up joint teams and pool their budgets.

The shake-up will see the law changed to reverse reforms of the NHS in England introduced by former health secretary Andrew Lansley in 2012.

Mr Hancock said: “The practical implication is that these changes will allow the NHS to work more closely together with the different parts of the NHS and, crucially, with social care and public health colleagues.

“At the moment there are rules set out in law that stop some of that working together. We’ve seen that that’s been a problem.

“At the heart of these reforms is the idea you take the budget for the NHS in a local area, and you get an integrated team that has social care, the NHS, the GPs and the hospitals, and they commission and they do the work to spend the money as effectively as possible.”

Health Secretary Matt Hancock
Health Secretary Matt Hancock (Tolga Akmen/PA)

He said the overhaul would reduce bureaucracy and “get funding and support closer to the front line”.

Mr Hancock has been criticised for introducing such reform at a time when NHS staff are exhausted from dealing with the Covid-19 pandemic.

But he insisted the plan would aid the health service and had been developed with it.

“You’ve got to do both,” he said. “When we come out of this pandemic, and we will, we need to build a better, stronger NHS.”

But shadow health secretary Jonathan Ashworth said it was not clear whether the proposed reforms will lead to less privatisation.

Shadow health secretary Jonathan Ashworth
Shadow health secretary Jonathan Ashworth questioned plans to reform the health service during the ongoing pandemic (UK Parliament/Jessica Taylor/PA)

“If you look at the detail of the reforms, it suggests that representatives of the private sector can actually sit on these new local care bodies and I think that’s the first time that’s happened in history.”

Mr Ashworth also said some other things were lacking in the plan.

He said: “As far as I can tell so far, there’s nothing in these reforms about a long-term plan for social care, there’s nothing in these reforms which will give us a plan to bring waiting lists down, which have ballooned in the last year and were huge before we went into the crisis.

“Those big waiting lists mean that many people are at risk of permanent disability (and) of losing their livelihood – we desperately need a plan to get those waiting lists down.”

According to the White Paper, reforms will be made to “help tackle obesity by introducing further restrictions on the advertising of high fat, salt and sugar foods; as well as a new power for ministers to alter certain food labelling requirements.”

It adds that the process for the fluoridation of water in England will be streamlined “by moving responsibilities for doing so from local authorities to central government.”

The Health Secretary will have more power to set objectives for NHS England, and will be able to intervene when local services are being reconfigured, such as the closure of hospitals.

The reforms also involve putting the Healthcare Safety Investigations Branch permanently into law as a statutory body to reduce risk and improve safety.

Sir Simon Stevens, chief executive of the NHS, said: “Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care.”

He said: “These proposals provide an important opportunity to speed up the move to integrate health and care at a local level, replace competition with collaboration and reform an unnecessarily rigid NHS approach to procurement.”

Dr Jennifer Dixon, chief executive of the Health Foundation, gave only a partial welcome.

She said: “One half of the proposals, to help local services collaborate better, could help improve care for patients and follows the direction NHS leaders are already taking.

“The other half, giving the Secretary of State more power over the NHS, is concerning, has no clear rationale and could take health care backwards.”

Richard Murray, chief executive of the King’s Fund, said: “By sweeping away clunky competition and procurement rules, these new plans could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing numbers of people who rely on multiple different services.”

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