Health Bill hands power to ministers, but misses the biggest health challenges

Responding to the introduction of the Health Bill, Hugh Alderwick, Director of Policy and Research at the Health Foundation, said:

‘The Health Bill includes welcome ambitions to join up health and care records to improve patient care, but hands too much power to ministers over the day-to-day running of the NHS and risks weakening the voice of patients.

‘At the heart of the bill are measures to scrap NHS England and hand broad powers to ministers to intervene in how the NHS operates. Accountability will always rise upwards to politicians in a tax-funded system like the NHS, and ministers are rightly in charge of setting direction and policy. But more independence and safeguards – for instance, over how local NHS leaders are appointed – are needed to avoid excessive politicisation in future.

‘Changes to the local management of the NHS in the bill might help simplify the system, but risk undermining the partnership work that's needed to improve heath and care. For example, the decision to remove mandatory local authority representatives from NHS integrated care boards could weaken the links between the NHS, social care and public health at a more local level. Time and energy will also be wasted as local bodies manage the reorganisation.

‘The abolition of Healthwatch looks set to diminish rather than strengthen the voice of patients and the public in the health service. A stronger replacement than currently on offer will be needed – combining institutional independence with sufficient resources and reach to gather local views and influence national decisions. 

‘The government’s ambition to join up health and social care records to improve patient care is an unambiguously good thing. But whether plans for a new single patient record can avoid the fate of past national NHS IT programmes is yet to be seen. Major questions remain about how the plans will tackle existing fragmentation of electronic patient record systems, how the data will be governed and the resources available to effectively implement it. Trust from patients, staff and the public will be essential for the plans to have any chance of succeeding.

‘Standing back, the bill is the latest example of successive governments focusing on the NHS over the broader health of the nation. As our recent analysis of healthy life expectancy showed, the UK’s health is declining, resulting in significant economic costs as well as substantial human toll. A cross-government strategy for rebuilding the UK’s health and reducing inequalities is desperately needed. The bill should be used as an opportunity to address this.'

• Read detailed reflections on the Health Bill from Hugh Alderwick, Senior Policy Fellow Phoebe Dunn and Deputy Director of Policy Tim Gardner, published in the BMJ.

Media contact

Jessica Clinkett
jessica.clinkett@health.org.uk
020 7664 4647