HEALTH AND CARE BILL PASSED: CAMPAIGNERS STILL NEED TO ACT
The deeply flawed Health and Care Bill was finally voted through by MPs and Lords, reaching Royal Assent on 28th April so will now become law.
There is still an opportunity to influence how the law will be interpreted in practice through the local Constitutions which need to be adopted by each Integrated Care Board (ICB).
These local constitutions are being developed behind closed doors, although some (not all) have been made publicly available for wider comment. The operation of the ICB may also involve issues beyond those specified in the constitution.
The Integrated Care Board chair is appointed by NHS England and approved by the Secretary of State. Boards are unlikely to take action unless there is pressure to do so from the health and care sector, local authorities, NHS staff and patients.
It will only be possible to affect the Constitution and functioning of the ICB if the health and care sector, local government, NHS staff and patients speak out, loud and clear.
KONP statement
The Health and Care Bill becomes an Act: why it matters to us all
THINGS YOU CAN DO
* Write to the Chair of your Integrated Care Board (ICB) to demand action on important issues arising from the Bill. See here for current list of ICS Chairs.
* Use this template letter as a guide and try to put the issues in your own words.
* See the list of KONP demands for ICSs
* You can use the letter to contact others in your area who are interested or involved in how the ICB will function.
* Here are suggestions for people to contact locally.
* See also We Own It letter-writing campaign to ICB Chairs demanding that no private companies are involved in ICBs
KONP AND THE HEALTH AND CARE BILL
Keep Our NHS Public opposed the Health and Care Bill 2021, which has just been voted through by MPs and Lords. The bill, and the guidance and regulations that come with it, signpost further fragmentation of the NHS, greater privatisation and damage to services and the workforce.
The bill also provides the legal framework required to implement the 40 or so Integrated Care Systems (ICSs) covering England, which pose a threat not least by allowing the private sector an even bigger role than it has currently, a role we believe is far too much already.
The Bill does not address any of the problems facing the NHS or social care and will distract from efforts to rebuild the NHS while it is still dealing with the Covid pandemic.
Here we provide information and analysis about the Health and Care Bill, Integrated Care Systems (ICSs), including the government’s White Paper, and its implications. You can also find how to get involved in our campaign and a range of campaign materials.
ICSs continue to pose a huge threat to the NHS as a universal, comprehensive health service that is publicly accountable, publicly funded and publicly provided.
The Health and Care BIll
Campaign materials
Letters and briefing notes
- KONP briefing on the Bill for members of House of Lords – and
- Template for covering letter for Lords briefing (please personalise)
- Letter from KONP President to members of Lords
- KONP briefing on the Bill for Local Authority Councillors
- Template for covering letter Councillors’ briefing (please personalise)
- KONP briefing for MPs. To find your MP, click here
- Greater Manchester briefing pack for Councillors
- Greater Manchester letter to KONP members about issues to raise with councillors
- Greater Manchester: Issues to raise with councillors
Leaflets
- A4 Oppose the Health and Care Bill (October 2021) black + white
- A5 leaflet about the Bill for staff (August 2021)
- A5 Leaflet about the Bill for patients (August 2021)
Model motions
Oppose the Health and Care Bill 2021: Model motion for trades unions
Useful presentations/speeches
Background information
- Keep Our NHS Public on the new Health and Care Bill (7.7.21)
- KONP’s evidence on the Bill to the Public Bill Committee consultation
- The Health and Care Bill: what it means for pay, terms and conditions for staff
- KONP evidence to the Department of Digital, Culture, Media and Sport, November 2021
- The Health and Care Bill and private companies’ access to patients’ data
- So far, there are few signs that Labour has grasped the overall purpose of the Bill, and there is at least one influential Lord whose amendments and extra-parliamentary interests in digital transformation tell a different story
Tentacles wrapped around the NHS
Parliamentary reading
- Bills before Parliament: The Health and Care Bill 2021-22
- Explanatory Notes to Health and Care Bill 2021-22
- House of Commons Library Briefing Paper
Integrated Care Systems (ICSs)
While the public has been kept in the dark, the NHS in England has been fragmented into around 40 areas that are now being turned into semi-independent ICSs. The Health and Care Bill aims to make these legal.
ICSs integrate organisations: each ICS brings together NHS bodies (such as hospital trusts), local councils and others (potentially private companies) to take joint responsibility for delivering services within a fixed budget.
KONP strongly supports the integration of services where this improves patient care: many NHS staff already work hard to achieve this. But ICSs are first and foremost about making the organisations within an ICS work together in order to reduce patients’ use of NHS services and save money.
Campaign materials
Leaflets
- Letter about ICSs to Councillors or MPs
- A4 leaflet: “Corporate bonanza for ICSs”
- A5 leaflet: “Stop the roll out of ICSs”
Model motions about ICSs
Background information
- Payment Schemes and Frameworks for Integrated Care Systems (ICSs)
The new payment scheme is a key element in plans to ‘transform’ the NHS, with ‘mature’ ICSs allocated their own, mainly fixed, annual payment which cannot be overspent. To read more about the NHS Payment Scheme, the Provider Selection Regime and ‘Payment Frameworks including ‘risk and reward sharing’, See also the paper on Value and how fixed budgets will be managed. - The (mis)use of ‘value’ in Integrated Care Systems (ICSs) to enable financial cuts.
When commissioning services, each ICS has to obtain best ‘value’ . To read more about ‘value’ in healthcare, including the concept of ‘overuse’ in ‘allocative value’, see (URL link to Resources Cabinet) - Government proposals for new legislation and deregulation will have implications for ICSs. See The Integrated Care System as a key site for private companies’ access to patient data.
- Integrated Care Systems: The threat to the NHS, social care and public health
- KONP’s response to NHSE’s recommendations to changing the law to facilitate ICSs
- Corporate Agenda for Integrated Care, KONP, January 2021
- An alternative vision: achieving democratic accountability, by Keep Our NHS Public, January 2021
- Social care: relationship to ICSs, by Keep Our NHS Public, January 2021
- NHS provider selection regime: response to consultation, July 2021 – a reduction in regulation and scrutiny, no need for tendering, and help for private providers
NHSE papers