Ministers are to push ahead with strategies to assume more power over the NHS in England, amid growing speculation that the head of the health service will quit this year.
The prepared shake-up instantly prompted concerns about why Boris Johnson has decided to set off a potentially destabilising reorganisation of the NHS in the middle of the Covid pandemic.
Matt Hancock, the health secretary, will on Thursday publish the first white paper on NHS reform since the union federal government’s hugely questionable health and social care bill in 2010.
The propositions would hand the health secretary a sweeping new “general power to direct NHS England on its functions”, which would reduce the independence its powerful president, Sir Simon Stevens, has actually built up and displayed throughout his seven years in the job.
There has actually been stress in between Hancock and Stevens, in the past and throughout the pandemic, including over worsening client waiting times for NHS care and scarcities of protective equipment for frontline staff.
The Guardian revealed last July that Johnson was planning to take more control over NHS England in an effort to regain powers the federal government delivered in the previous restructuring of the health service.
The white paper likewise consists of plans to provide the health secretary more control over the NHS’s arm’s- length bodies, such as the Care Quality Commission and Health Education England, along with the organisation led by Stevens, who advised Tony Blair when he was prime minister.
However NHS bodies and health specialists cautioned ministers the organized powergrab could backfire, distract personnel from taking care of patients and lead to the government being blamed by the public for any problem or debate in the service, such as out of favor plans to downgrade a local healthcare facility.
Hancock stated the upcoming NHS reform expense would liberate the NHS from “difficult administration” created by the shake-up in 2012 managed by the then health secretary, Andrew Lansley, and cause health and social care services working more closely together for the benefit of clients. It will build on enhancements in the NHS seen during the pandemic, he believes.
However Danny Mortimer, the chief executive of the NHS Confederation, which represents health service trusts, said: “There will be lessons to learn from the pandemic– for federal government and the NHS– but it would be incorrect to conclude that greater ministerial control would have caused an improved reaction.
” The NHS is already one of the most centralised health systems worldwide and ministers need to resist the temptation to centralise it further.”
NHS England personnel who work closely with Stevens anticipate him to stand down this year and it is thought he would not wish to have his wings clipped in the way the government is proposing.
One NHS expert stated: “Under this new legislation the NHS’s remit would need somebody with less power than Simon and somebody who’s prepared to have less power. Simon quite enjoys his power.”
Nigel Edwards, the president of the Nuffield Trust health thinktank, said: “Ministers may come to regret all the brand-new powers they are set to be approved over health center closures and downgrades [and] instructions to NHS England.
” As earlier federal governments discovered to their hazard, centralising power suggests you centralise blame and develop more pressure to interfere.”
The timing of the shake-up has actually raised concerns, offered the NHS is still immersed in fighting the pandemic and faces major challenges over holes in its labor force, hold-ups in people accessing treatment and how it can halt the rise in diseases such as cancer, obesity and mental illness.
“Boris Johnson must explain why a reorganisation in the middle of the most significant crisis the NHS has actually ever faced is his pushing top priority,” said Jonathan Ashworth, the shadow health secretary.
The proposal that NHS bodies no longer have to instantly tender contracts for services worth more than ₤ 615,000– another Lansley legacy– will be warmly welcomed as rolling back the increasing privatisation of care seen over the last few years.
But Dr John Lister, secretary of the project group Keep Our NHS Public, stated personal health firms would still be able to bid for crucial agreements, consisting of for providing information services. “There is no proposition to roll back the agreements of services already outsourced, and even terminate the agreements when they expire,” he stated.
Scientific commissioning groups, the regional bodies which hold the NHS spending plan in an area, would be subsumed into 42 brand-new legal entities called integrated care systems– groups of NHS bodies and local councils interacting to integrate and improve health and social care. But Edwards cautioned of likely dispute in between each ICS’s two distinct boards and the regional health and wellbeing board, made up of elected members of the local council.
The Department of Health and Social Care said: “By acting now, the federal government can make irreversible some of the advantageous modifications where Covid has catalysed brand-new and better ways of working and clear the path for enhancements into the next years such as delivering on manifesto dedications including 50,000 more nurses and 40 brand-new hospitals.”