An Act of denial that endangers the NHS
The Health and Care Bill is now on its way to getting Royal Assent as all objections and opposition has been brushed aside. The Government has got its way and will divide the NHS into over 40 separate units/Integrated Care Systems (ICS) acting virtually autonomously.
This is an Act of intent, deliberately breaking up the NHS and facilitating the spread of parasitising private interests, looking to make £billions from funding for public services. It does nothing to address the state of emergency the NHS is now in.
The intent is never clearer than in allowing the conflict of interest of private bodies directly (sitting on boards and committees) or indirectly (through provider collaboratives) to influence provision of NHS services.
This legislation will drastically worsen the state of emergency by imposing costly and disruptive reconfiguration. The Government has doggedly refused to agree to regular workforce review, despite 110,000 vacancies and catastrophic staff morale, yet without an adequate workforce the NHS simply cannot deliver safe and compassionate care.
It has now legalised the discharge of patients without a care plan, endangering their ongoing management and safety. The refusal to ensure a statutory duty to provide emergency care for everyone requiring it in an ICS area poses additional significant risks.
The Act allows the Secretary of State to interfere early to determine local reconfigurations including hospital closures, thwarting public consultation, and weakening the say local authorities and councillors have on NHS plans.
The ‘Care’ element of the Act is a misnomer, bringing in the grossly inequitable social care cost cap when only direct care costs paid by an individual count to the limit, not the overall cost of their care. Poorer people are more likely to lose all their available resources including their home, whilst the rich keep all but the first £86,000. This exacerbates social inequalities and disproportionately affects those living in more impoverished parts of the country.
A clear danger is there for NHS and care workers and trade unions, as the Act will threaten nationally negotiated and protected terms and conditions, and allows the Secretary of State to unilaterally end professional regulations on standards and training of NHS staff.
With limited budgets and soaring inflation further eroding already inadequate funding (leading inevitably to swift cuts in services), the battle on the Bill may be over, but the fight for the NHS, for patients and staff must now be more intense than ever.
Tony O’Sullivan and John Puntis, Co-Chairs Keep Our NHS Public