Brief summary of the NHS Bill
In short, the Bill proposes to fully restore the NHS as an accountable public service by reversing 25 years of marketization in the NHS, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities.
This is necessary to stop the dismantling of the NHS under the Health and Social Care Act 2012. It is driven by the needs of local communities. Scotland and Wales have already reversed marketization and restored their NHS without massive upheaval. England can too.
The Bill gives flexibility in how it would be implemented, led by local authorities and current bodies.
- 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 and social care services,
- 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 and the World Trade Organization’s General Agreement on Trade in Services,
- abolish the NHS Commissioning Board (NHS England) and re-establish it as a Special Health Authority with regional committees,
- plan and provide services without contracts through Health Boards, which could cover more than one local authority area if there was local support,
- allow local authorities to lead a ‘bottom up’ process with the assistance of clinical commissioning groups (CCGs), NHS trusts, NHS foundation trusts and NHS England to transfer functions to Health Boards,
- abolish NHS trusts, NHS foundation trusts and CCGs after the transfer by 1st January 2018,
- abolish Monitor – the regulator of NHS foundation trusts, commercial companies and voluntary organisations – and repeal the competition and core marketization provisions of the 2012 Act,
- integrate public health services, and the duty to reduce inequalities, into the NHS,
- 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,
- require national terms and conditions under the NHS Staff Council and Agenda for Change system for relevant NHS staff,
- centralise NHS debts under the Private Finance Initiative (PFI) in the Treasury, require publication of PFI contracts and also require the Treasury to report to Parliament on reducing NHS PFI debts,
- abolish the legal provisions passed in 2014 requiring certain immigrants to pay for NHS services
- declare the UK’s agreement to the proposed Transatlantic Trade and Investment Partnership and other international treaties affecting the NHS to require the prior approval of Parliament and the devolved legislatures,
- require the government to report annually to Parliament on the effect of treaties on the NHS.
Previous versions of the Bill
The first proposal for a Bill was made in August 2014 by Professor Allyson Pollock and barrister Peter Roderick.
The August 2014 proposal was put out for consultation, a process which ended in late December 2014.
Based on the consultation Peter Roderick and Allyson Pollock drafted another version, finalised on 21 February 2015.
On 11 March 2015, 12 MPs from five political parties tabled the first National Health Service Bill in the House of Commons, based on the second version of the proposed NHS Reinstatement Bill. The Bill ‘fell’ when Parliament ended before the May 2015 General Election, and was retabled in the current session of Parliament.