The must-read stories and debate in health policy and leadership.

It was big and it was bold – the bill laid before Parliament yesterday will give ministers the power to seize major decisions from the NHS.

The government pushed ahead with its publication, despite reservations from the new health and social care secretary and NHS leaders.

The most attention-grabbing measures concern clauses which would give the health secretary a general power to direct over NHS agencies, including NHS England and Improvement, and over local service reconfigurations.

Most of the bill’s proposals resulted from a detailed consultation exercise conducted by NHSE. However, the moves to give greater powers to the Department of Health and Social Care were introduced by former health secretary Matt Hancock and have been retained by his successor.

These proposals are widely opposed by NHS leaders.

NHS Providers chief Chris Hopson told a Westminster Health Forum event this morning: “We are very nervous [about a system in which ministers] have a power that enables them to dictate practical priorities such as funding and health priorities.”

Rob Webster, West Yorkshire and Harrogate Partnership chief executive, told HSJ such a move was “counter to the spirit” of what leaders want.

He said: “[The new direction] either needs to be dropped from the bill, [which is] my personal preference, or there needs to be some real clarity about the conditions upon which it will be used. At the moment, it’s unclear to me under which circumstances you would use it. That’s a dangerous place to be.”

The bill also sets out the long-awaited legislative underpinning for integrated care systems, with clauses which will put integrated care boards and partnerships on a legal footing.

Going green quickly

The UK has enshrined in law its commitment to reach carbon net zero emissions by 2050, with the NHS overall aiming for 2040 (for emissions it directly controls).

A few brave (or foolhardy?) integrated care systems – such as Cornwall and Bristol – are aiming for 2030, but is that realistic?

The resounding answer is yes, according to the NHS’ chief sustainability officer Nick Watts.

In an interview with HSJ, Dr Watts pointed to individual trusts’ reductions in their carbon footprint by moving away from high-emitting medical gases as proof that change can happen quickly, and he expects some parts of the NHS to “go further faster” than the national plan.

Dr Watts said local plans for net zero, which must be completed by mid-January and end of March 2022 by trusts and ICSs respectively, need not be perfect but should “head in the right direction”.

From reading Dr Watts’ comments, Daily Insight gleans a more gentle approach to oversight by NHS England, compared to other areas of performance. Dr Watts said: “No one is perfect and it’s going to be a learning process.”

Given that improved public health and a sustainable planet are – ultimately – the main objectives of the race for net zero, you would think that motivating staff to accept the challenge would be easier than in other transformation programmes.

Dr Watts certainly believes the NHS is responding to the call. He said: “The energy and enthusiasm out there suggests to me we’re going to have our work cut out just trying to capture and harness that energy, rather than asking people to come along on our journey.”