Health Bill

Summary#

The Health Bill is a Government bill that would amend existing laws, mainly the National Health Service Act 2006 and the Health and Social Care Act 2012. Its stated goal is to make provision about health and social care; it is not yet law, and its start dates would be set later. The supplied material does not include the full parent Acts, so I cannot verify every change against current law.

  • It would abolish NHS England and transfer functions to the Secretary of State for Health and Social Care, with some functions also moving to integrated care boards (ICBs).
  • The Secretary of State would gain broad powers to direct ICBs about whether, when and how they use their functions. ICBs would have duties concerning health inequalities, patient involvement and choice, and innovation.
  • It would abolish the Health Services Safety Investigations Body (HSSIB) and transfer its functions to the Care Quality Commission (CQC). It would also abolish the Healthwatch England committee and arrangements with Local Healthwatch organisations.
  • It would change NHS foundation trust governance, including removing members and councils of governors, and let the Secretary of State set limits on a trust’s expenditure by order.
  • It would let the Secretary of State make regulations for licensing and other rules for medical devices in Great Britain. Those regulations could set licence conditions, fees and offences.

What it means for you#

  • Patients: ICBs would have to promote patient involvement and choice, and work to reduce inequalities. These are duties on ICBs, not a guarantee that a patient will get a particular service or choice. The bill does not set out a new application or appeal process for these duties.
  • Health bodies and staff: NHS England would be abolished, with functions, property, rights and liabilities transferred under schemes. The bill allows transfers of staff-related and other liabilities, but the supplied material does not set out the practical transition.
  • NHS foundation trusts: Members and councils of governors would no longer have their current roles under the amended rules. The Secretary of State could set expenditure limits by order, after consulting the trust and publishing the order.
  • People who use or make medical devices: Regulations could cover supplying, advertising, manufacturing, importing and wholesale dealing in devices, as well as device safety and availability. The bill enables regulations; the detailed rules and which licences would be required are not set out in the supplied material.
  • People using local health and care information or safety services: HSSIB’s functions would move to the CQC, and Healthwatch England and Local Healthwatch arrangements would be abolished. The supplied material does not explain what local public-involvement arrangements would replace them.

Money#

The bill allows financial assistance and resources to be provided by the Secretary of State and ICBs, but no cost estimate is given. No publicly available information.

  • Transfer schemes can move property, rights and liabilities, including criminal liabilities.
  • Medical-device regulations could impose fees on licence applications or licence holders.
  • The bill does not provide figures for staffing, transition, regulatory or other implementation costs.

What is unclear#

  • How many staff, what assets and which liabilities would transfer, and when the changes would take effect.
  • Which limits or exceptions would apply to the Secretary of State’s powers to direct ICBs in practice.
  • How ICBs would carry out their new duties, and how patients could raise concerns if those duties were not met.
  • What medical-device licences, conditions, fees and offences the later regulations would create.
  • What public-involvement arrangements would replace Local Healthwatch organisations.
  • The supplied material says explanatory notes were ordered to be published, but does not include them.

Case for#

  • The bill appears intended to put more NHS functions under direct ministerial responsibility. A possible argument for this is that it could make responsibility for national decisions clearer.
  • Transferring HSSIB functions to the CQC could bring safety investigation functions within an existing health regulator.
  • Duties on ICBs concerning inequalities, patient involvement, choice and innovation could make these matters part of their formal responsibilities.
  • A regulation-making power for medical devices could let the government set licensing and safety rules in detail.

Case against#

  • The Secretary of State’s broad direction powers could reduce ICBs’ room to make local decisions. The supplied material does not show how that power would be limited in day-to-day use.
  • Removing foundation trust members and councils of governors would reduce those formal roles in trust governance.
  • Abolishing Healthwatch bodies and arrangements could leave gaps in local public involvement; the bill does not explain what would replace them.
  • Major transfers and new regulatory powers could require staff and public money, but the supplied material gives no cost estimate or implementation detail.