A leaked document has suggested that the government is planning to reverse reforms of the NHS in England introduced under David Cameron in 2012.
The Department for Health and Social Care has said that it did not comment on leaks, but a spokesman has since added that details would be set out in due course.
The leak claims that Prime Minister Boris Johnson is planning to give the Health Secretary more direct control over NHS England, reversing the changes made by former Prime Minister David Cameron and his then Health Secretary Andrew Lansley which put NHS England at arms length from the Secretary of State.
The 2012 Health and Social Care Act, brought in by the coalition government, gave more control over budgets to GPs and other clinicians, while greater competition with the private sector was encouraged.
At the time the changes attracted criticism from professional bodies representing doctors, nurses and other NHS workers as well as opposition MPs.
Under the latest proposals, set out in a leaked document published by health news website Health Policy Insight, there will be ‘enhanced powers of direction for the government’ to ‘ensure that decision makers overseeing the health system at a national level are effectively held to account’.
This would mean that the NHS and local authorities will be left to run services and told to collaborate with each other, a direct change from the competitive tendering for contracts that takes place at the moment. It is hoped that this will tackle bureaucracy and encourage health services from hospitals to GP surgeries and social care to work more closely.
Danny Mortimer, chief executive of the NHS Confederation, said: “There is often anxiety about ‘another NHS reorganisation’, but the NHS and the partners we work with across other public services have been on this journey now for several years. This is the logical next step. However, there will be important detail to work through. Ensuring these changes fully involve our partners in local government will be high up the list, as will getting accountability to the government right given the NHS is a public service that costs over £100 billion a year to run. The government and regulators will need to strike the right balance.
"While ministers have always been active in setting policy, the NHS has benefited over the last decade from having more control over day-to-day operational matters delegated to it. There is concern though that in an overly centralised system, regardless of the arrangements at a national level, the reforms need to better empower local NHS and care leaders to lead – they are best placed to run health and care services for their local communities.”
