Re-tabling the NHS Reinstatement Bill 11th July 2018

Professor Allyson Pollock and Peter Roderick have been discussing the re-tabling of the NHS Reinstatement Bill in the House of Commons on 11th July 2018 with Eleanor Smith, MP for Wolverhampton South West. We are delighted that an MP with Eleanor’s experience and commitment wants to do this.

You can find here the proposed Bill that we have sent to Eleanor, which contains a number of changes from the previous Bill as presented by Margaret Greenwood MP, and the Explanatory Notes that we have prepared are here.

A brief overview of the proposed Bill is below.

 

Overview

In short, the Bill proposes to fully restore the NHS in England by 2021 as an accountable public service by reversing nearly 30 years of marketization, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies which plan and provide integrated services and accountable to local communities.

The Bill gives flexibility in how it would be implemented, led by current bodies, including local authorities.

It would:

  • reinstate the government’s duty to provide the key NHS services throughout England, including hospitals, medical and nursing services, primary care, mental health and community services,
  • integrate health services under the Secretary of State, whilst allowing delegation of public health services to local authorities, and allowing for integration of social care services following and subject to further legislation,
  • declare the NHS to be a “non-economic service of general interest” and “a service supplied in the exercise of governmental authority” so asserting the full competence of Parliament and the devolved bodies to legislate for the NHS without being trumped by EU competition law (for so long as the UK is an EU Member State) and the World Trade Organization’s General Agreement on Trade in Services,
  • exclude the NHS from international trade deals,
  • require the NHS Commissioning Board (NHS England), clinical commissioning groups (CCGs), NHS trusts, NHS foundation trusts, and local authorities, including combined authorities and elected mayors, to develop a ‘bottom up’ process so that by 2021 services would be planned and provided without contracts through regional and local public bodies – which could cover more than one local authority area if there was local support, and taking into account English devolution – to be known as Strategic Integrated Health Boards and Local Integrated Health Boards,
  • allow Health Boards to employ GPs, end pay beds and private practice in NHS hospitals and end contracts for GP services with commercial companies,    
  • abolish NHS England, CCGs, NHS trusts and NHS foundation trusts, following completion and approval by the Secretary of State of the Health Boards, 
  • repeal the competition and core marketization provisions of the 2012 Act, and abolish Monitor – the regulator of NHS foundation trusts, commercial companies and voluntary organisations,
  • re-establish Community Health Councils to represent the interest of the public in the NHS,
  • stop licence conditions taking effect which have been imposed by Monitor on NHS foundation trusts and that will have the effect of reducing by April 2016 the number of services that they currently have to provide,
  • introduce a system for collective bargaining across the NHS,
  • impose a duty on the Treasury to minimise, and if possible to end, the expenditure of public money on private finance initiatives in the NHS in England, and
  • abolish the legal provisions passed in 2014 requiring certain immigrants to pay for NHS services.