Labour would force clinical commissioning groups to include a wider range of clinicians and reverse the increased private patient income cap, shadow health secretary Andy Burnham has told HSJ.
In his speech to the Labour party conference, Mr Burnham confirmed that if the party won the 2015 general election he would introduce legislation to repeal the Health Act 2012 in the following Queen’s speech.
However, speaking afterwards, Mr Burnham agreed with HSJ’s suggestion that Labour would be unable to immediately repeal all the changes brought in by the Health Act. “We’ll carry forward what we like,” he said.
The key health stories from the Labour conference
He said a repeal bill would keep some of the act’s clauses, for example instance retaining those that created “new entities” such as health and wellbeing boards. The proposed bill would also amend the role of CCGs to focus them on designing services “clinician to clinician” rather than commissioning them, Mr Burnham said.
Mr Burnham has previously said he favoured handing CCG budgets to local authorities. He told HSJ the details of Labour’s plans would be fleshed out following the publication of the party’s Independent Commission on Whole Person Care, chaired by former Department of Health adviser and GP Sir John Oldham, in the new year.
The repeal bill would also cut the cap on the amount foundation trusts can earn on private work from 49 per cent of their total turnover to “single figures”, he said, and completely repeal part 3 of the bill which sets out the role of competition in the NHS.
Mr Burnham said part 3 would be replaced by legislation to make the NHS the “preferred provider” of NHS services. The policy proved controversial when Mr Burnham first announced it during his tenure as health secretary in 2009. Many commentators viewed it as a “U-turn” while others questioned its legality under EU law.
Mr Burnham told HSJ the policy was legal as health services came under part B of EU procurement rules, meaning they did not have to be put out to tender. He said the Health Act had opened the NHS up to more competition and could put that principle at risk. However, he said he had taken legal advice that it would be possible to “pull it back out” by 2015.
“The reform the NHS needs is service reform, starting by keeping people in their homes and we need something that’s going to enable that as quickly as possible,” he said. “NHS preferred provider is that vehicle.”
He insisted this reduction in competition would not make NHS organisations “complacent” but would provide stability and was effectively giving them the “first chance to change”.
Asked what his roll back of competition would mean for patient choice Mr Burnham said he disagreed that they were “two sides of the same coin”.
“The choices we were giving to people in government were quite meaningless, things like ‘[which provider] do you want to go to for your hip operation?’,” he said.
“I believe we can deliver more advanced notions of choice and control in an integrated system than in a fragmented system.” He said having “one valued team” working around individuals would actually allow for better patient choice, for example around being able to give birth or to die at home.
Mr Burnham also revealed that 26 councils had signed up to become “whole person care innovation councils”, spearheading the integration of health and social care services under a Labour-led programme. Of these 22 are Labour, one is Conservative and three have no overall control. The authorities will have regular contact with Labour’s health team and be encouraged to share information between themselves.
Mr Burnham said: “When we were in government people may have seen us as ‘here’s what we want you to do and here’s how we want you to do it’. I’m open minded about the different models [of integration]… At the moment all I’m saying is merge the existing budgets for health and social care.”
Whole person care innovation councils
- Gateshead LABOUR
- Islington LABOUR
- North East Lincolnshire LABOUR
- Lancashire – no overall control
- Derbyshire LABOUR
- Plymouth LABOUR
- Liverpool LABOUR
- Wirral LABOUR
- Brent LABOUR
- Southwark LABOUR
- Luton LABOUR
- St Helens LABOUR
- Knowsley LABOUR
- Birmingham LABOUR
- Halton LABOUR
- Wigan LABOUR
- Bolton LABOUR
- Bury LABOUR
- Rochdale LABOUR
- Oldham LABOUR
- Manchester LABOUR
- Salford LABOUR
- Tameside LABOUR
- Stockport – no overall control
- Trafford - CONSERVATIVE
- Isle of Wight – no overall control