Collaboration, rather than competition, is a better way for the
NHS and the wider health and care system to respond to today's
challenges, a new report by the Health and Social Care Committee
says.
Competition
The NHS Long-term Plan: proposals for legislative
change Report welcomes, in principle, NHS England and
NHS Improvement's proposals to promote collaboration, especially
the proposal to repeal section 75 of the Health and Social Care
Act 2012 and revoke the regulations made under it.
The Committee believes that collaboration, rather than
competition, is a better way for the NHS and the wider health and
care system to respond to today's challenges.
Competition rules add costs and complexities, without
corresponding benefits for patients and taxpayers in return.
Choice and competition can help raise standards and encourage
innovation, but, as an organising principle, collaboration is a
better way to manage the rising demands on health and social
care, improve joined up care for patients and deliver better
value for taxpayers. However, the NHS should not become a
monopoly as this would not be in the best interests of patients.
Integrated care
The Report also recommends that the law should rule out
non-statutory providers holding an Integrated Care Provider (ICP)
contract. Until the law is changed, the Committee strongly urges
that any ICP contract should be held by an NHS body.
In addition, the Committee supports the proposal to give the
Secretary of State powers to create new NHS trusts, but this
power must not be used by the Department or national bodies to
impose a form of integration on local health and care services or
as threat to force organisations to collaborate.
Now is not the right time to establish integrated care systems as
separate legal entities as the committee was told that doing so
would involve far wider legislative changes and there is no
appetite for another major reorganisation of the NHS. These new
systems must however demonstrate the highest standards of
openness and transparency.
NHS leadership
The NHS at a national level must support, encourage and empower
local leadership. Local areas are working hard to collaborate and
integrate care around patients but too often having to do so in
spite of rather than with assistance from current legislation
which is why legislative changes are necessary to remove some of
the hurdles.
While the Committee supports – in principle – the proposal for
NHS England and NHS Improvement to merge, concerns have been
raised about the degree of central control that could result from
this merger. The Committee would like to see more detail on how
any unintended consequences of this merger will be avoided.
Cross-party endorsement of legislative proposals
MP, Chair of the Health and
Social Care Committee, says:
“The pragmatic proposals we heard throughout this inquiry are
broadly welcome. This Report also represents cross-party
endorsement of suggested changes, and presents an opportunity to
make integration easier, to encourage greater collaboration and
reduce some of the burdens from competition rules.
“Nevertheless, the proposals in their current form are
NHS-centric – we would like to see greater consideration of the
wider system which the NHS seeks to integrate.
“It is clear that there is no appetite for another large-scale,
top-down reorganisation of the NHS and within the current hung
Parliament any such major change would not pass the House of
Commons. These proposed reforms are being led by the NHS itself
and I hope will receive cross party support.”
“Local health providers continue to work to collaborate and
integrate care around patients, in spite of current legislative
obstacles and these proposed reforms are designed to remove some
of the barriers that can get in the way”
“We hope the incoming Prime Minister will support the need for
reform and that a commitment to take this forward will form part
of the next Queen’s Speech. The Committee looks forward to
conducting pre-legislative scrutiny.”
