Labour has pledged to target duplication and bureaucracy they say has been caused by the Health Act 2012, raising the prospect of organisational changes if they form the next governement.
The announcement forms part of the party’s 10 year plan for health and care, published today.
The plan does not state which organisations it would target, but the focus may raise doubts about the prospects for national arm’s length bodies created by the legislation, such as the NHS Trust Development Authority and NHS England. Other potential targets for savings could include NHS commissioning support units, or clinical commissioning groups.
Labour’s ongoing “zero based review” of all government spending has already identified £100m of savings which they say could be generated by scrapping the competition rules which were enshrined in law by the act.
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However, the 10 year plan says a Labour government would go further.
It says: “We will consult with the [health and care] sector on how to release even larger savings from the new set of organisations created by the reorganisation, including by addressing potential duplication of responsibilities and further reducing bureaucracy.”
Shadow health secretary Andy Burnham has previously pledged to keep clinical commissioning groups, telling HSJ they should become the operational arms of health and wellbeing boards, and the party today states it is not planning a top down re-organisation for the service.
The future roles of NHS England, commissioning support units, the TDA and the Care Quality Commission are not explained in the 10 year plan.
Under Labour’s proposals Monitor will be stripped of its role as an economic regulator for the health sector, but would have a new role driving integration.
Monitor would also be responsible for examining the financial viability of entire health economies, rather than individual organisations within them. The regulator would “be able to rate health economies on the overall viability of the entire local systems and their medium term viability”.
As set out in the NHS Five Year Forward View, NHS England is currently reviewing the roles of national and regional bodies including the NHS Leadership Academy, NHS Improving Quality, academic health science networks, and clinical senates.
Speaking to reporters ahead of the launch of the report yesterday, Mr Burnham said: “We are going to restore democratic responsibility to the secretary of state for health.
“We do not want, and I do not believe it’s right to have an operationally independent NHS England. That in my view is not sufficiently accountable to people.
“I don’t want to see CCGs in that framework taking arbitrary decisions about whether people can have operations because they don’t approve of their [body mass index] or whether they smoke or not.
“We need a national health service which is about entitlements to healthcare; accountable to parliament and the secretary of state… But there is role for NHS England setting operational policy at a national level. So it will change things but we are not changing organisations for the sake of it or dismantling organisations only to create new ones.”
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