Over the past few months I have had the privilege of working on the Health and Social Care Bill, scrutinising the detail of the Bill during its Commons committee stage. I strongly believed this would be a chance for us to reinvigorate our NHS and give it a renewed life to achieve its objective of providing high-quality and free at the point of use healthcare, fit for the 21st century. I approached this role determined to stop the Bill from becoming a cronies charter under the Tories.
I was spurred to seek elected office because of the Conservative Party’s disastrous reforms implemented nearly a decade ago. The Lansley Act was focused solely on the reorganisation and marketisation of the NHS instead of focusing on what really matters: services delivered to patients. There were more warnings from experts than you can count that this would undermine care. They were right and the new Bill was a last ditch attempt to save face.
Over the last months, together with Labour colleagues, I have been pushing the Government to increase accountability, transparency and integration. Unfortunately, the Government refused all of the Labour’s amendments to the Health and Care Bill, meaning the Bill will be unable to bring the required openness and transparency that aids accountability I have been pushing for.he Government’s decision will have terrible consequences and it’s choice to proceed without adding in better local accountability and challenge in the system will need fixing in the not too distant future. The risks of which we heard in evidence from Sir Robert Francis. A system needs to be put in place to challenge the culture and give a voice to local patients and the public, otherwise new rules will fail as the old ones did.
The position of the NHS as default for most clinical services will remain and the Bill will not favour more privatisation, but it won’t stop outsourcing where a case can be made and a process followed.
Although the overall outcome of the Bill was disappointing, we did see some small victories. The Bill has reversed much of the Lansley Act, which I welcome.
However, we still do not have a strong approach to integrated care. The proposed Integrated Care Partnerships (ICPS) appear to be mainly vehicles for discussion with no powers or duties. This is not the solution that is needed for the rising number of people with multiple long-term conditions. The Bill also fails to address major problems around workforce retention and recruitment, and crumbling infrastructure.
Backlogs and a strained workforce are not the result of the pandemic alone. They are a result of a decade of mismanagement and underinvestment. We urgently need reform that will address these serious and fundamental issues. As the Lords debate the Bill, I hope to see these problems being discussed.