15.04.15
More detail needed on Labour’s repeal of HSCA
This week the main political parties launched their 2015 manifestos, with Labour’s health commitments drawing both plaudits for its ambitions but criticism for its detail on funding.
One of the key pledges made by the party is to “repeal the Health and Social Care Act to scrap David Cameron’s privatisation plans and put the right values back at the heart of the NHS”.
However, the party claims in its health manifesto this can be done without another top-down reorganisation (although this is not repeated in the main manifesto). It claims “we will work through the structures we inherit”.
As part of the plans it looks like clinical commissioning groups and health and wellbeing boards created by the Act are here to stay, but as Emma Spencelayh, a senior policy advisor at the Health Foundation, notes: “This does then raise the question of how Labour will be able to meet its manifesto commitment to repeal the legislation.”
She added that Clive Efford’s Private Members Bill shows how Labour might amend some of the Act’s most controversial measures on competition but “this would not represent a full repeal which is what the manifesto indicates is Labour policy”.
Labour says its first Queen’s Speech would bring forward a bill to repeal the Health and Social Care Act.
“Our Bill will restore proper democratic accountability for the health service, and will introduce tougher safeguards on hospitals’ ability to raise Private Patient Income – in order to ensure that NHS patients are always put first. It will repeal the market framework, removing the role of Monitor and the Competition and Markets Authority as economic regulators enforcing competition, and scrapping the ‘Section 75’ regulations that have effectively made tendering statutory,” it says.
“This will be replaced with an ‘NHS Preferred Provider’ framework, to ensure that the NHS is not destabilised by market competition, and we will draw a clear distinction between not-for-profit and for-profit providers by giving voluntary sector organisations the benefit of longer and more stable arrangements.”
These pledges are all very noble in their aims, but we do have to go back to the question of how this will affect the structure of the NHS – something the part is not 100% clear on.
Even Chris Ham, chief executive of The King’s Fund, who welcomed the manifesto for its “decisive break with the policies of the recent past in its rejection of markets and competition” expressed some concern.
“It is hard to see how Labour’s plans to dismantle the Health and Social Care Act could be achieved without disruptive structural changes to the NHS,” he said.
I think many of us welcome the sentiments of Labour’s manifesto pledges, but there does need to be more detail on how the party will manage to achieve commissioning for a single health and care service without a further top-down reorganisation.
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