Health and Social Care Act
On Tuesday 27th March 2012, the Health and Social Care Bill gained Royal Assent from the Queen to become the Health and Social Care Act 2012 and is now law.
It is the single most extensive reorganisation of health services since the NHS was founded over 60 years ago. As a Bill, it underwent over 200 hours of Parliamentary scrutiny and was subject to over 1,000 amendments.
The core principles of the Act aim to allow doctors and nurses will be able to tailor services for their patients, give more choice to patients over how they are treated, and reduce bureaucracy in the NHS.
Throughout the Bill process, the Patients Association was very involved in ensuring that the patient voice was always heard in the debates. We worked with MPs, peers, the Department of Health, the NHS Future Forum and other bodies, telling them what patients were most concerned about in the Bill.
So what does the passage of the Health and Social Care Act actually mean?
What the coalition wanted:
• GPs to take responsibility for £60bn of NHS funds
• Competition to be extended to more NHS services
• Reduced bureaucracy and fewer managers
• An increased role for the private sector
• Backing from every professional group involved.
What they have had to compromise on:
• NHS professionals such as hospital consultants and nurses being given greater say in spending
• Competition limited to quality not price
• More managers to look into perceived risks
• All providers to be assessed for their suitability to run services.
The shape of things to come:
• Clinical commissioning groups (CCGs) replacing primary care trusts
• CCGs deciding upon care for patients, advising them where to go for treatment and paying the bills
• Some of the day-to-day control of the NHS passing to the new NHS Commissioning Board, which will manage the CCGs at a national and local level
• Responsibility for public health issues like obesity, smoking and alcohol abuse being handed to local councils
• All hospitals becoming foundation trusts and competing for treatment contracts from CCGs
• The cap on how much hospitals can earn from private patients rising from as little as 1.5% to 49%
In May 2011, in responses to concerns about the Bill from patients and professionals, the Government announced a pause in the progress of the Bill through parliament. We decided to take stock and carried out a survey and six independent Listening Events to find out your views about the proposed changes to the NHS. Over 1,000 patients, carers and members of the public responded to our survey and our Listening Events were attended by over 200 members of the public. We found that patients do want improvements to the NHS, with a reduction in bureaucracy and waste, but that they don’t believe the reforms will achieve this. Patients also want a stronger local voice, but feel the proposal for HealthWatch as the mechanism to achieve this will not work, as it is not resourced properly and is to be carried out by volunteers. The move to ‘any qualified provider’ and GP commissioning are also seen by patients to be moving the focus away from patients and towards the commercial side of healthcare. Shared decision-making and choice are welcomed by patients but they need to be backed up by information so that patients are empowered to be involved in their healthcare. To read our report on the Listening Events and survey click here.We could not have achieved our Listening Events without the help of our members and also our wonderful Ambassadors who helped coordinate the Events. Our thanks go to:
And Sheila Try
To read our Listening Exercise report, please click here
Commissioning of the majority of services will move from Primary Care Trusts (PCTs) and fall to groups of GP practices, called GP consortia (renamed as Clinical Commissioning Groups). Many callers to our Helpline are concerned about GPs holding 80% of the NHS budget and are worried that GPs will be spending so much time balancing the books that they will be spending less time with patients. Patients are also concerned that GPs will buy in the cheapest service instead of the one that offers the most clinical benefits to patients.
We did......a survey of GP consortia and a round table meeting to pull together a Blueprint of what good patient engagement looks like when commissioning services.
Public Bill Committee
We also submitted our responses to the Bill committee regarding the reforms. You can read more about our submissions to the Public Bill Committee here.