Government's NHS reorganisation plans raise questions over 'creeping privatisation'

Under the plans, more than 200 clinical commissioning groups (CCGs) will be replaced by 42 larger integrated care systems.

The law will also do away with the need for competitive tendering – whereby the NHS has to encourage organisations to bid to provide services - and also change the make-up of decision-making boards.

The Government said the changes, expected to come in during the Spring of 2022, would improve outcomes in healthcare and to tackle inequalities in outcomes, experience and access.

But a senior Leeds city councillor said concerns had been raised about how the law could allow private healthcare companies into the NHS.

Coun Fiona Venner, the council’s executive member responsible for health, said: “Concerns that have been raised with me include whether parts of the act represent creeping privatisation of the NHS.

“In the legislation, there is the option for private sector providers to be on the partnership boards.

“There isn’t any plan for that to happen in West Yorkshire at the moment, but Virgin Care are on partnership boards in some parts of the country.”

She said there had also been fears around the repeal of section 75 of the last health and care bill from 2012, as it could be the end for the need to competitively tender NHS contracts to outside organisations.

She added: “Campaigners and people on the left campaigned against that vociferously at the time, because it hugely extended the role of competitive tendering in the NHS, so it is ironic they are now concerned about this clause being removed.

“You would think this could be a good thing, but my concern about it is that it shows the lack of trust people have in the Government and procurement. There have been terrible decisions in the last 15 months around contracts to friends for PPE that’s defective.

“The concern around repealing this part of the act is that it will make it easier to award contracts without due process.”

The comments came during a discussion at Leeds City Council’s adults and health scrutiny board about plans for a Leeds integrated care system.

During the meeting, co-opted member Dr John Beal said: “We have to ask ‘what difference is it going to make to our communities?’

“In my long career, I have been through between 15 and 20 reorganisations of the NHS. Each one has promised things would get better, but each one has been costly, in terms of the finances but also on the effect of the staff.

“We are just coming out of a pandemic, we see major problems in the NHS – increasing waiting lists, people not getting treatment or a diagnosis. We are short of GPs and nurses.

“Is it not that we ought to be putting all our efforts in addressing those problems in the NHS? Is it the right time to be doing this? Should we not be carrying on doing what we are doing so well without going through this major reorganisation?”

The Government’s recent Health and Care Bill focuses on how a new health and care system should be based on “integration rather than competition”.

The bill also includes proposals to give the Health Secretary new powers to direct NHS England and decide how some health services are organised.

Another section of the bill includes new proposals for restricting the advertising of high fat, salt and sugar food and drink, with a 9pm watershed on television and on-demand programmes, as well as a prohibition on advertising of unhealthy foods online.

NHS Chief Executive Sir Simon Stephens previously said about the plans: “They go with the grain of what our staff and patients can see is needed, by removing outdated and bureaucratic legal barriers to joined-up working between GPs, hospitals, and community services.”

He added that the reforms would “undoubtedly both help tackle health inequalities and speed the recovery of care disrupted by the Covid pandemic.”

But a Commons research paper on the proposals said many were warning against new powers for the secretary of state and private sector involvement.

Dr Jennifer Dixon, chief executive of the Health Foundation, said the new powers were: “politically driven and risks taking healthcare backwards”, while the NHS Confederation warned that the timetable for making sure integrated care services could take on functions by April 2022 was extremely tight.

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