Matt Hancock, Secretary of State for Health, has this week revealed the government’s commitment to reversing the Health and Social Care Act introduced under David Cameron in 2012. However, this is not an unexpected turn of events. Within the cabinet, senior Tories have been voicing their grievances regarding the top-down reorganisation of health services for many years, citing bureaucracy, competition, and moves towards forced privatisation as the primary burdens in the health service since Andrew Lansley’s reforms.
Under the plans devised by government officials, there is an optimistic rhetoric, one that prides itself off the predicted outcomes of better integration, devolution, innovation and pragmatism. Hancock has outlined the government’s dedication to both placing the focus back on the health of the population, and removing the health inequalities that have dominated the UK for the last decade. In terms of organisation, the new system would be more localised than before, with already existing integrated care systems becoming more populous across the country, and thus more impactful in supporting a particular region’s wellbeing.
More contentiously, under these proposals the NHS would see a reversal of its statutory independence, giving ministers greater responsibility and power over the workings of the healthcare system - a somewhat controversial move amidst already existing concerns about the government’s handling of the COVID-19 pandemic. Hancock’s response to this, however, was clear when challenged: the pandemic, in his eyes, has highlighted the ever growing (and frankly imminent) need to ward off ill health in the first place.
Nonetheless, critics of these propositions - namely the opposition and medical executives - have questioned the timely nature of the report, warning against the implementation of a sudden overhaul to an already overwhelmed institution. Shadow Health Secretary, Jonathan Ashworth also highlighted the lack of attention given to the problem of unprecedented waiting times within the account, alluding to the idea that the government have chosen an inappropriate time to suggest rapid structural reorganisation.
In addition to Labour’s critique of the leaked White Paper, Dr Chaand Nagpaul - council chair of the British Medical Association - has emphasised the need for more careful consideration in the time leading up to administrative changes, and stated that any readjustments “must not be rushed through while doctors are still tackling the winter surge in infections, hospitalisations and tragically, deaths”. With year-long hospital waits for over 225,000 people in England alone, the government is resided to the dilemma of acting too hastily and complicating an already exhausted system, or overseeing a healthcare crisis and not acting at all.
However, in the face of growing concerns around reforming the institution, there has been notable support in the long-term advantages posed by the outlined proposals. For instance, the Chair of the Academy of Royal Colleges, Helen Stokes-Lampard, stated that these are welcomed propositions that symbolise a long awaited shift beyond traditional NHS boundaries, as well as the changes that the NHS will need moving into the recovery stage post-pandemic.
Additionally, there has reportedly been “widespread agreement” across the NHS on the proposals, according to the Chief Executive of the NHS Providers organisation, Chris Hopson, with other top medical officials too drawing on the prospect of a strengthened relationship between local authorities and the institution.
Through evaluating such varied reactions to the White Paper, it appears as though the main response to these plans is a partial and conditional support - whilst there is disagreement about the timing of this report, there are perhaps visible (and appreciated) signs that the government have not only attempted to build on improvements seen within the last year, but are also taking the decisive action necessary to bring the NHS back into a manageable, efficient state.
Only time will tell if these proposals will lead the health service down a path of centralised administration and political power grabbing or a path of integration and community led initiative - until then, we must again place our trust in the higher echelons of the government to listen to expert opinion, a trust many have lost this year.
