The second reading of the Health and Care Bill is taking place this afternoon in the House of Commons, with a statement on the legislation being read by Health and Social Care Secretary Sajid Javid. The Bill has proved controversial in terms of its shake-up of NHS procurement changes, enactment of Integrated Care Systems in England and provision of closure powers to the Secretary of State.
The Bill was first introduced to the House last week by Mr Javid, who stated that it would make the NHS “less bureaucratic, more accountable, and more integrated in the wake of COVID-19”. The Health and Care Bill will see Integrated Care Systems placed on a statutory footing, so they become responsible for commissioning and bringing together local NHS and local government services, such as those covering social care and mental health. It strips out previous NHS procurement rules regarding tenders, gives intervention powers to the Secretary of State for Health in local service reconfiguration changes, such as abolishing NHS arm’s length-bodies and closing A&E units.
Labour has made clear its opposition to the changes contained in the Bill, and the timing of its parliamentary process. Its shadow health minister, Jonathan Ashworth, criticised the legislation, saying that “Labour will be fighting NHS privatisation and urging MPs to vote against this Bill” and that it is “the wrong Bill at the wrong time”.
During the second reading, this is the first opportunity for MPs to debate the main principles of the Bill. At the end of the debate, the Commons decides whether the Bill should be given its second reading by voting, meaning it can proceed to the next stage. The King’s Fund has urged the Government and Parliament to avoid specifying in legislation granular detail about how collaboration should be achieved at ‘place’ level, and instead allow local flexibility.
Also, a group of influential charities and organisations have written to the Government ahead of the Second Reading to urge them to amend the Bill to ensure that England has “robust, independence projections” of the health and social care staff the country will need.
The Bill’s introduction to Parliament was delayed from late June until July the 6th. This delay has led to concern among NHS senior chiefs regarding the implementation time period available to the NHS to set about the changes needed. As a result of the delay, guidance on how the new laws should be implemented has had to be postponed or issued in outline form while the parliamentary process continues. A local board paper, published by Lancashire and South Cumbria ICS on 7th July, says “ongoing delays” in the publication of national policy and guidance are “resulting in a prolonged period of uncertainly for our workforce”.