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NHS bill 'will let Andrew Lansley wash his hands of health service' - guardian.co.uk & 38Degress - How to email your MP

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NHS bill 'will let Andrew Lansley wash his hands of health service'

Legal opinion funded by campaigners suggests 'hands-off' clause will remove the health secretary's accountability

, health editor

The Guardian,

The health secretary will be able to "wash his hands" of the NHS after forthcoming legislation which will take away his duty to provide a national health service, according to legal advice funded by campaigners.

The legal opinion, commissioned and paid for by members of the 38 Degrees website, justifies the widespread public concern about the government's health reforms, in spite of Andrew Lansley's assurances that he has listened and responded to criticisms, they say.

The independent legal team says the health and social reform bill removes the health secretary's responsibility for NHS provision through a "hands-off" clause designed to give autonomy to commissioning groups.

David Babbs, executive director of 38 Degrees, said one legal opinion suggested responsibility for provision would instead fall to an unknown number of "clinical commissioning groups". Babbs said: "The so-called 'hands off' clause … removes political accountability, which is the only real control voters have on the way the NHS is delivered. We won't be able to fire people on regulatory bodies or private healthcare companies when things go wrong.

"None of us voted for these fundamental changes to the NHS. They weren't in any party's manifestos, or the coalition agreement, so 38 Degrees members have clubbed together to get legal advice to convince MPs that the changes shouldn't be pushed ahead and that the public's concerns need to be taken seriously."

Dr Clare Gerada, chair of the Royal College of GPs, said the legal advice gave cause for concern: "Having seen these legal opinions, they raise serious concerns for GPs. As family doctors, we want to ensure any changes to the NHS safeguard its future and benefit patients. The advice of these legal experts brings this into question. That is worrying and the government needs to respond."

The legal opinion warns that EU and domestic competition rules, which apply to business, will now apply to decisions about who provides healthcare and the running of the NHS. It says the new structure will work to the advantage of private health companies that have experience of complex procurement processes and legal teams that can challenge decisions.

A second lawyer, Rebecca Haynes of Monkton Chambers, said: "The complexity of the regime and the administrative burden in complying with the rules (which are constantly evolving through a rapidly expanding body of case law) cannot be underestimated … The relative ease with which bidders can bring claims in the high court at any stage of the procurement has led to an increased appetite for litigation and administrative challenge."

A Department of Health spokeswoman said the health secretary's responsibility for "promoting a comprehensive health service" will not change. She added: "The bill does not change current UK or EU competition legislation or procurement legislation or the areas to which they apply."

• This article was amended on 30 August 2011. The original said Dr Clare Gerada was the president of the Royal College of GPs. This has been corrected to chair.

anonymous (not verified)
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Health and wellbeing boards: Making them work

Why are we doing work in this area?

Health and wellbeing boards are an important feature of the NHS reforms and have emerged from the NHS listening exercise with strengthened powers.

This project has three main aims.

  • To gain insight into how local authorities and their health partners are implementing health and wellbeing boards in the context of the government’s NHS reforms, its vision for adult social care and the localism bill.
  • To capture the overall approach of a sample of English councils in establishing these new arrangements, supported by a more detailed examination of the experience of  two early implementer sites whom The King’s Fund has been assisting.
  • To identify the lessons that could be applied to the roll-out of health and wellbeing boards elsewhere, the issues that local authorities and their health partners need to address in the next stage of their development and the implications for policy.

What are we doing as part of this piece of work?

The project is rooted in work with two local authorities and their health partners, to facilitate the establishment of their local health and wellbeing boards. It will involve:

  • a literature search to establish current knowledge of health and wellbeing board implementation and an evaluation of similar initiatives to promote local joint working
  • telephone interviews with health and wellbeing board leads in a sample of around 50 early implementer sites (drawn from a representative mixture of councils, regions and urban/rural)
  • further interviews with main stakeholders in two early implementer sites – Surrey and Lambeth.

A final report on this work will be published in the autumn 2011.

http://www.kingsfund.org.uk/current_projects/health_and_wellbeing_boards...

anonymous (not verified)
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In it for the long haul: The challenge for public health

With local government assuming responsibility for public health and the wider health landscape set to change significantly as a result of the Health and Social Care Bill, public health is at a crossroads. This report explores the key opportunities and challenges facing public health in its new landscape.

Free publication can be download at http://www.ippr.org/publications/55/7898/in-it-for-the-long-haul-the-cha...

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