Health and Care Bill 2021 briefing for MPs

Keep Our NHS Public is opposed to the Health and Care Bill 2021 and do not believe it will solve any of the problems the NHS is currently facing. We are inviting individuals to send this briefing to their MP to encourage them to vote against the Bill. You can find out who your local MP is on the Parliament website.

Health and Care Bill 2021

Briefing for MPs

This Bill:

  • Has not applied any of the messages from the pandemic
  • Will override local democratic input and gives excessive powers to the Secretary of State
  • Fails to address the crises in NHS waiting times and workforce, public health or social care
  • Fails to make it a duty for new NHS boards to provide emergency services
  • Builds in conflict of interest by allowing private representation on the new NHS boards making contract decisions
  • Imposes cost-capping and threatens draconian service cuts
  • Worsens post-code lottery and inequality
  • Permits dangerous discharge from hospital without assessment and care plan in place
  • Fails to guarantee duty of openness and candour
  • Threatens heightened health inequalities with the dominant digital first policy
  • Places patient data at risk of abuse
  • Creates new risks from deskilling and deregulating sections of the NHS workforce

The Government’s Health and Care Bill passed its second reading in Parliament on 15 July.

We have been shocked at the absence of informed debate and opposition from politicians to a Bill that will undermine public control and provision of the NHS as a national health service aiming to provide comprehensive, universal treatment and care in response to need, free at the point of use. Even while the pandemic escalates, the government asserts their response to Covid has been a success built on full co-operation with the private sector, a lesson they now wish to apply to the NHS as a whole.

The Bill does nothing to solve the crises in funding, staffing shortages, mental health, and social care services, crumbling estate and other major problems facing the NHS. Instead, it enables increased involvement of the private sector.

The Bill:

  • allows private companies (including many multi-national corporations accredited by NHS England) to sit on ‘Integrated Care System’ (ICS) boards and their committees, making decisions about how public money is spent.
  • repeals the legal requirement to assess patients who may require ongoing support and to have a care package in place before they are discharged from hospital, allowing ‘discharge to assess’, a controversial policy [1] placing increased demand on community services which are currently woefully inadequate.
  • repeals Section 75 of the Health and Social Care Act (2012). This will not end competition, but there are powers to reduce regulation of the NHS ‘market’ by exempting contracts which include clinical care services from the Public Contracts Regulations and their protections.
  • grants the Secretary of State major powers, including the political control of NHS bodies by placing senior staff onto decision making boards. New “Henry VIII” powers [2] will be created to second staff into NHS England and abolish NHS-related bodies, with new opportunities to intervene in local decisions.
  • puts a strict cap on funding, so ICS boards will be expected to ration NHS services in line with their funding, rather than funding being provided to match need. Already, the UK spends far less on healthcare than other comparable countries like France or Germany.
  • introduces a Payment Scheme which can vary by area, provider, and patient characteristics, with the private sector to be consulted on the details, fragmenting the financial basis of the national NHS.
  • gives no explicit guarantee that all meetings of an Integrated Care Board and Partnership will be held in public, that papers must be published in advance, and that the public can raise questions.
  • promotes a ‘digital first’ approach to patient care. Although digital options are helpful and welcomed by some, they represent a major barrier for many because of lack of digital access or literacy, language barriers, learning disability etc. and can be used to deny care. [3]
  • will confirm NHS Digital’s power to share patients’ data with third parties, including a wide range of private companies, raising concerns for patients’ privacy.
  • represents a threat to professional staffing and patient care, allowing greater use of less skilled staff and replacing professional expertise with digital applications.
  • promotes deregulation of the NHS, reducing oversight of how contracts are awarded, and undermining environmental, social, and labour protections. Plans to disband regulatory bodies that oversee the conduct and competence of the professions will put patients at risk.

 

The British Medical Association among other organisations is strongly opposed to this bill [4].

We urge you to do all you can to oppose the Bill.

[1] https://www.bmj.com/content/370/bmj.m3747

[2] https://www.parliament.uk/site-information/glossary/henry-viii-clauses/

[3] https://www.theguardian.com/us-news/2021/jul/02/algorithm-crucial-healthcare-decisions

[4] https://www.bma.org.uk/bma-media-centre/wrong-bill-at-the-wrong-time-bma-council-calls-on-mps-to-reject-health-and-care-bill