The Government’s Health and Social Care Bill, setting out measures – including the disbanding of England’s primary care Trusts and strategic health authorities – designed to “modernise the National Health Service and put patients at the heart of everything it does”, was published on 19 January.
In unveiling the measures, Health Secretary Andrew Lansley (pictured) said modernising the NHS was “a necessity, not an option, in order to meet rising need in the future”. The Department of Health said the proposed steps, including the establishment of a new NHS Commissioning Board, with GP consortia handed power to commission health services for local people from “any willing provider”, would save the NHS over £5 billion by 2014/15, “and then £1.7 billion every year after that – enough to pay for over 40,000 extra nurses, 17,000 extra doctors, or over 11,000 extra senior doctors every year”. The majority of the savings would, the DH said, “come from a significant reduction in bureaucracy” following the abolition of strategic health authorities and primary care Trusts, and a reduction in management staff by an estimated 24,500 posts. The changes are expected to “pay for themselves” by 2012/13”. A DH statement said: “The proposed changes will lead to better quality care, more choice, and improved outcomes for patients, as well as long-term financial savings for the NHS, which will be available for reinvestment to improve care. There will also, for the first time, be a defined legal duty for the NHS and the whole care system to improve continuously the quality of patient care in the areas of effectiveness, safety, and, most importantly, patient experience.” The Bill includes proposals to (in the DH’s words): “bring commissioning closer to patients” by giving responsibility to GP-led groups; increase accountability for patients and the public by establishing HealthWatch and local health and wellbeing boards within local councils; “liberate the NHS from political micromanagement” – by supporting all Trusts to become Foundation Trusts and establishing independent regulation; improve public health by creating Public Health England, and “reduce bureaucracy by streamlining arm’s-length bodies”. Under the plans, patients will, the DH claims, be “more involved in decisions about their treatment and care”, while the NHS will be “more focussed on results that are meaningful to patients by measuring outcomes such as how successful their treatment was and their quality of life, not just processes like waiting list targets”. The Bill also signals the Government’s intention that local councils and clinicians should increasingly “come together to shape local services”. Andrew Lansley said the legislation marked “the start of a cultural shift to a patient-centred NHS”.
