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Government planning huge overhaul of how NHS is run, leaked document reveals

Written by on 6 February 2021

Details of a huge overhaul of how the NHS is run have been revealed in a leaked government document.

The reforms would reverse controversial changes brought in by David Cameron’s coalition government in 2012 and slim down the role of private providers in the health service.

The policy document, leaked to the website Health Policy Insight, lays out plans for increased integration between care providers but also gives substantially more power to the government.

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The health secretary would be responsible for setting priorities for the NHS and would be handed powers to put fluoride in water supplies and change the labelling on fatty foods.

Labour’s shadow health secretary Jon Ashworth said the government need to “explain how a structural reorganisation in the midst of the biggest crisis the NHS has faced” would benefit patients.

A paramedic at work in the rear of an ambulance outside the Royal London Hospital, in London, during England's third national lockdown to curb the spread of coronavirus. Picture date: Wednesday January 20, 2021. Image: NHS workers have been on the frontline during the coronavirus pandemic

He added: “It’s an admission that the David Cameron reforms from 10 years ago were an expensive counterproductive distraction… the corona pandemic has shown that health and care services can work together without structural reform.”

The legislation would mark a change from decades of reforms aimed at encouraging competition within the NHS.

Local councils and health providers would be obliged to collaborate when providing care under a network of “integrated care systems”.

This would scrap changes made in 2012 that encouraged competition and the use of private companies.

It would also mean a majority of functions carried out by clinical commissioning groups – the groups of GPs who currently commission services for their patients – would be transferred to integrated care systems.

It’s hoped the reforms would reduce bureaucracy and make it easier for care to be delivered to individuals through a range of services.

The executive summary of the white paper set out the broad aims saying, “our legislative proposals capture the learning from the response to the pandemic to support the NHS to deliver in a way that is more integrated, less bureaucratic, and more accountable”.

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Former health secretary Jeremy Hunt welcomed the proposed changes, telling the BBC “last year was the first year in history where, across the world, there were more over-65s than under-fives, so we are all having to deal with this big change in our health provision of the growth in older people and what that means is you need a lot more joined up care”.

The bill would give a legal footing to changes that have already been taking place as part of the health service’s long-term plan.

The head of the NHS, Sir Simon Stevens, has said he wants integrated care systems to cover the whole of England by April 2021 with many already in place.

A Department of Health and Social Care spokesperson said: “From tackling bureaucracy to driving forward the integration of health and care services, we are rightly considering where changes need to be made to help us build back better.”