All Change at the NHS

February 13, 2021 7:38 PM
Originally published by Babergh South Suffolk Liberal Democrats

lkj (Photo by Ross Findon on Unsplash)

Suffolk MP and Health Secretary Matt Hancock is a busy man. Not content with fighting the pandemic he has also found time to announce plans to reorganise the NHS

As the White paper says "These changes will enable the NHS and local authorities to avoid needless bureaucracy in arranging healthcare services while retaining core duties to ensure quality and value". The fact much of this complexity was added by the last set of reforms to the NHS undertaken by a Conservative Health Minister in 2010 is somewhat glossed over but that's generally the way!

The proposals contain a number of proposed changes which are to be welcomed most particularly the focus on integrating health and social care provision and the current requirements to tender to the private sector. Response overall has been supportive of the general approach well summed up by Sarah Wollaston, Hunt's predecessor as health committee chair, who was a Conservative and then Liberal Democrat MP before leaving the Commons in 2019,. She praised the broad direction of the plans, saying they brought a "welcome end to expensive and time-consuming contracting rounds". The white paper unveiled by Hancock "mostly reflects changes asked for by NHS that needed legislative change but also one government add that wasn't asked for, greater powers for ministers to meddle," she added.

There are some major questions that need to be addressed as any reforms are considered

1 Learning. Mr Hancock says the need for reform has been highlighted by lessons learnt from the pandemic. Odd really when the Prime Minister keeps postponing an independent review of response to Covid.

One suspects there are many lessons to learn above and beyond the way the Health Service is organised

2 Social Care. On entering Downing Street last summer the Prime Minister said he had a plan for social care ready to go. Nine months on we still don't know what it is. Many thousands of care home deaths would have been avoided if untested people hadn't been returned to homes from hospital early in the pandemic. Reorganising before setting out plans for social care seems foolhardy.

3 Timing Is now the right time to be focussing on changing organisation. Health workers are exhausted, waiting lists for treatment are soaring and money to invest in the service is tight after our covid debt splurge. Anyone involved in reorganisations know they are time consuming and draining. Is now the right time to be doing this?

4. Funding Even before the pandemic the NHS was creaking as years of under-funding saw growing waiting lists, falling A&E response times and up to 100,000 unfilled vacancies. Without adequate funding for health and social care, changing the oranisation will only fiddle around the edges. As an employee once said to us after a business reorganisation

"It is the same circus just run by different clowns"!!

The White Paper is pretty silent on funding

5.Greater centralisation. "Medical matters are matters for ministers," Hancock told MPs. "NHS England will have a clinical and day-to-day operational independence, but the secretary of state will be empowered to set direction for the NHS and intervene where necessary.". As Sarah Woolaston asked, "Is greater Ministerial control of the NHS really the answer?" The Guardian editorial summed it up most effectively when it said " It is not clear that an empowered Mr Hancock would have avoided many of the most significant failures of the pandemic to which he conspicuously did not refer in the Commons on Thursday. These include major failures of equipment provision, staffing shortages, lack of proper training for the Nightingale hospitals, poor coordination, IT deficiencies, the abortive test-and-trace system, and the appointment of inadequately qualified cronies to management roles.

You can make your own mind up by reading the White Paper at Integration and innovation: working together to improve health and social care for all (HTML version) - GOV.UK (