The Health and Care Bill 2021–22 outlines major changes to NHS rules and structures in England. The bill is the largest legislative shake-up of the NHS in a decade – and undoes many of the changes introduced by the Coalition government in the last round of major NHS legislation back in 2012. In this briefing, we focus on the key changes in the bill and highlight issues and questions for the committee to consider. We draw on our previous analysis of the reform proposals and their potential impacts.
Broadly speaking, the bill is a story of two halves. The first is a set of changes designed to promote collaboration in the health system. Encouraging collaboration to improve care makes sense – and goes with the grain of recent NHS policy. But the benefits of these changes should not be overstated and there is a risk that the new NHS structure is complex, vague, and not adequately designed to support the bill’s aims for better integration between NHS and wider services.
The second is a set of changes to increase the power of the Secretary of State for Health and Social Care over the day-to-day running of the NHS. These changes lack rationale and warrant scrutiny. The bill also includes a set of wider changes on workforce policy, social care, public health, and other areas.
Read our response to a call to evidence from the House of Commons Public Bill Committee on the Health and Care Bill.