The Health and Care Bill (2021-22) represents a rushed, top-down reorganisation of our NHS. It will fail to integrate health and social care, erode local accountability, and give powers to the Health Secretary to hand major contracts to the private sector without scrutiny.
The Government claims that the Bill builds on the NHS’s own proposals for reform, aiming to make it less bureaucratic, more accountable, and more integrated, and that it has incorporated lessons learnt from the pandemic.
Like many in the health sector, I agree with the objective of more integrated health and care services, but I am concerned that this is the wrong Bill at the wrong time.
Private sector involvement in NHS services has created a fragmented and marketised system. The Health and Social Care Act 2012, which I have consistently opposed, introduced competitive tendering. It requires NHS commissioners to advertise many larger contracts to private firms and it prevents proper integration. The 2012 Act was, in my view, wasteful and it forced privatisation of health services.
Instead of this being a simple Bill to end competition and foster local collaboration, I am concerned that it allows further outsourcing, permitting the private sector to sit on local boards, and it does not reinstate the NHS as the default provider of services.
This is a moment of great pressure on the NHS, yet there is nothing in the Bill to address the greatest challenges facing the NHS or wider reform of adult social care and workforce pressures. I strongly believe the Government’s focus must instead be on ensuring that services are appropriately staffed and have the resources they need, addressing the crisis in social care, and giving the NHS workforce the pay rise they deserve.
I supported the Opposition’s reasoned amendment to the Bill in an attempt to stop its progress. Disappointingly, Government MPs voted against this amendment and it was defeated. Whilst I also voted against the Bill at second reading, it passed with the support of Government MPs and will now progress to committee stage.
The NHS is our greatest institution. I am committed to upholding its founding principles as a comprehensive, integrated, and public NHS that is there for all of us when we need it. I will continue to resist the Government’s plans to allow further privatisation with no oversight.