Intended for healthcare professionals

News Briefing

Health and Care Bill: What changes do healthcare leaders want to see?

BMJ 2021; 374 doi: (Published 15 July 2021) Cite this as: BMJ 2021;374:n1806
  1. Gareth Iacobucci
  1. The BMJ

The BMA has said it won’t back the government’s Health and Care Bill. With the bill passing its second reading in the House of Commons, Gareth Iacobucci looks at the proposals

What is the purpose of the bill?

The legislation has two major aims.1 The first is to remove legal barriers to integrating healthcare in England by ending the internal market and reversing most of former health secretary Andrew Lansley’s controversial Health and Social Care Act 2012. The second is to shift substantial powers away from the NHS and back to the secretary of state for health and social care, giving Sajid Javid more power to intervene in the running of the NHS and in local decisions.

What does the bill say on competition?

Legal requirements introduced in the 2012 act to promote competition and competitively tender some clinical services will be revoked. The rationale is that this approach led to a fragmented and at times wasteful delivery of services, with organisations finding it difficult to cooperate and join up services across the system and spending a lot of money on bidding for contracts. This change was requested by the leadership of NHS England and has now been backed by the government.

How will the NHS structure change?

The 106 GP led clinical commissioning groups that were established (originally as 211 bodies) under Lansley’s act to coordinate local services will be abolished next April. In their place will be larger integrated care systems, which already exist in non-statutory form in 42 geographical areas. …

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