Sometimes referred to as the Lansley Act (after its originator, David Cameron’s then Health Secretary Andrew Lansley), this Health and Social Care Bill was proposed early in 2011, passed in 2012 and implemented from April 2013.
Under the Act:
- The NHS became no longer the responsibility of the Secretary of State (Health Minister), but commissioned by a new arm’s length body (NHS England).
- Primary Care Trusts and Strategic Health Authorities were abolished and replaced by 207 new Clinical Commissioning Groups (CCGs).
- CCGs were required to ensure that services were broken down into contracts, and those above a value of £615k (with some exceptions) had to be made available for tender to all bidders, including those in the private sector.
- The powers of the foundation trusts’ regulator, Monitor (since merged with NHS Improvement) were extended to ensuring that competition laws were applied to NHS contract tendering.
- The Act raised the maximum share of their income NHS foundation trusts can raise from private patients from an average of 2% to 49% (Source National Health Executive)
These changes have made it much easier for private companies to acquire NHS contracts, and much harder for NHS services to be kept in public hands. It is also harder to make the Government accountable for the state of the NHS, due to the change in responsibility of the Secretary of State.
A radical restructure of the NHS that forced the decentralisation of it, was also required alongside £20 billion of savings in the following three years. These cuts were justified by the Conservative Liberal Democrat Coalition Government under its austerity measures.
There was significant vocal opposition to the Bill at the time, and the Government at the time announced a ‘pause’ in the passage of the Bill to allow reflection. It was however passed in 2012.
