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The Health and Care Bill is a government power grab that opens the doors to privatisation

4 min read

Every second the NHS spends on this top down reorganisation is a second less spent on bringing down waiting lists and improving care.

Earlier this month we celebrated the 73rd birthday of the NHS. A creation of Aneurin Bevan and a Labour government to deliver publicly funded healthcare to all who need it. 

The shocking waiting lists, exhausted staff, and overstretched services are far from the healthcare system Bevan had in mind. The task ahead of the new health secretary, to restore the NHS to its founding principles, is monumental. 

There are now hundreds of thousands of people waiting over a year for treatment – over 7,000 waiting over two years. Many more have yet to come forward for the treatment they need. The reports on waiting lists make for shocking reading. Cancer patients who couldn’t get appointments and who’s cancer has been diagnosed too late. Elderly people waiting in pain for hip operations. Those with cataracts waiting for eye surgery at risk of blindness. 

Children bore the brunt of the pandemic as their schools closed. For many, this left them without the day-to-day support from the NHS too – mental health conditions that could have been picked up at school left undetected. Speech and language problems that could have been assessed in school not caught early. Children didn’t just miss out on their education, but their health suffered too. 

It should be a national shame that the most vulnerable in our society – the elderly, children and disabled, have been let down so badly. The pandemic alone cannot be blamed. The reality is that the NHS was in crisis before the pandemic struck. Waiting lists have been rising month on month, year on year, for a decade. The NHS unable to keep up with demand. Waiting time targets set a decade ago are routinely missed. 

The Bill does nothing to improve local accountability, while expanding the Secretary’s powers to do everything

So why, in the face of this crisis, is the NHS’ energy focused on a wasteful, top-down reorganisation in the middle of a pandemic? 

The health service has faced 30 reorganisations since 1974. The next iteration of reform – the Health and Care Bill, which has its second reading today, contains sweeping changes to NHS structures, changes to regulation of social care services, a watered-down commitment to tackle junk food advertising and a wide-ranging power grab for the Secretary of State. 

The Bill abolishes Clinical Commissioning Groups and replaces them with Integrated Care Systems. It reorganises the NHS into 42 areas, with populations of up to 4 million people. 

This leaves these unwieldy ICSs as the voice of local health systems with huge, diverse communities. It is unlikely that these remote bodies will have proper regard for the unique and sometimes competing health needs of local communities. The Bill does nothing to improve local accountability, while expanding the Secretary’s powers to do everything from reorganise a local A&E to veto the appointment of the next chair of NHS England. This is a dangerous move which hands the Secretary of State more power without accountability for his actions. 

Concerns have been raised about the role of private providers in health services. There’s nothing in the Bill to stop the awarding of private contracts to Tory donors – as we have seen in the pandemic. Alongside this, private providers can be handed a seat on the ICS board. Labour will challenge this at every step.  

The Bill was not drafted by Sajid Javid. The new Health Secretary even wrote to the Prime Minister asking for the Bill to be delayed. According to reports, he said there were “significant areas of contention” yet to be resolved. 

He was overruled by the Prime Minister. 

So now, in the face of rising infections, a waiting list that continues to break records month after month and our hardworking NHS facing exhaustion and burnout, he is asking the NHS to press ahead with reforms even he isn’t convinced by. 

Every second the NHS spends on this top down reorganisation is a second less spent on bringing down waiting lists and improving care, better supporting the NHS workforce or modernising our hospitals.


Justin Madders is the Labour MP for Ellesmere Port and Neston.

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