Key Facts

• Clause 34 substitutes proposed new section 7A for the existing section 7A in the National Health Service Act 2006.
• Clause 35 introduces a power for the Secretary of State to confer public health functions on NHS England or ICBs by direction.
• The clause supports greater integration and collaboration within health and care services.
• Public health funding for 2019-20 was down 15% compared to before the 2012 Act.
• There were cuts of nearly half for support in the workplace, a quarter for NHS health checks, and a quarter for smoking cessation programmes.
• Clause 34 allows delegation to NHS England, local authorities, combined authorities, and integrated care boards.
• Amendment 108 is proposed in clause 36.
• It aims to prevent subsection (2) from superseding Part 4 of the Health and Care Act 2021.
• Concerns have been raised about HSSIB's access to information and its independence.
• Clause 36 was debated previously.
• Steve McCabe raises issues with clauses 37 and 62 in the Health and Care Bill.
• The MP seeks clarity on the general power to direct NHS England under clause 37.
• Clause 37 introduces powers for the Secretary of State to give directions to newly merged NHS England.
• Clause 62 amends the National Health Service Act 2006 by repealing the duty on the Secretary of State and NHS England to promote autonomy.
• The changes are designed to support integration, collaboration, and local leadership within the health system.
• The repeal of the duty to promote autonomy is set out in clause 62.
• NHS England receives more than £100 billion of spending, equivalent to 40% of the Government’s revenue budget.
• A parliamentary mechanism could ensure public confidence that there is no Executive overreach or low-level direction on healthcare service operation.
• Amendment 102 defines 'relevant Health Overview & Scrutiny Committee'.
• Amendment 103 requires consultation with all relevant committees and consideration of clinical advice.
• Amendment 104 mandates publishing a statement demonstrating public interest.
• Amendments 102 and 103 would require consultation with health overview and scrutiny committees before making reconfiguration decisions.
• Amendment 104 requires publishing a statement demonstrating that any decision is in the public interest.
• Clause 38 introduces new intervention powers for the Secretary of State to oversee NHS service reconfigurations at any stage, ensuring transparency and accountability.
• Clause 38 is criticized as granting excessive control over NHS service changes.
• Witnesses from NHS Confederation, NHS Providers, BMA express concern about centralization and loss of local accountability.
• The clause mandates notification to the Secretary of State for any potential reconfiguration circumstances.
• Current system relies on local health overview and scrutiny committees.
• The Health Service Journal suggests the Secretary of State is considering scrapping or watering down plans to give himself power over local service changes.
• A DHSC spokesman stated that the proposals would maintain NHS clinical and operational independence while ensuring transparent oversight by the Secretary of State.
• Paragraph 4(3)(b) in schedule 6 gives the Secretary of State power to decide particular results for NHS commissioning bodies, which McCabe believes could override local processes.
• Chris Skidmore faced a campaign to save Cossham Hospital when he was elected in 2010.
• The North Bristol Trust neglected its duty to communicate effectively with the public, according to an IRP report.
• Schedule 6 of the Health and Care Bill defines 'reconfiguration of NHS services' as changes that impact service delivery or availability at the point of use.
• Skidmore is concerned about potential politicisation of reconfiguration decisions leading up to election times.
• McCabe references the reconfiguration process in Bristol as an example of wider consultation, clinical leadership and patient involvement.
• The process involved closing one A&E service to build two specialised hospitals.
• There is a need for clarity on where the Government will get their clinical advice.
• Clause 38 allows for earlier intervention by the Secretary of State at any stage of reconfiguration processes.
• Current system limits intervention to referrals from local authority health overview and scrutiny committees under specific circumstances.
• Guidance will be produced in collaboration with NHS partners.
• Clauses 39, 40, and 41 are discussed.
• Schedule 7 is to be considered as part of the Bill.
• Clauses 42, 44 to 50 will also be debated.
• Clause 39 repeals section 179 of the Health and Social Care Act 2012.
• Clause 40 removes the Secretary of State’s powers to appoint trustees for NHS charities.
• Clause 42 makes changes to the licensing regime for NHS trusts.
• Clause 44 transfers oversight functions from the NHS Trust Development Authority to NHS England.
• Clause 45 grants NHS England power to give directions to English NHS trusts about exercising their functions.
• Clause 47 requires NHS England to make recommendations to the Secretary of State for intervention orders against underperforming NHS trusts.
• Clause 49 gives NHS England the power to appoint the chair of the board of directors for an NHS trust.
• Clauses in the Bill address technical changes to NHS trusts without significantly altering their substance.
• McCabe agrees with the principle of not changing the provider landscape but questions the two-tier system created by the Bill.
• Clause 42 deals with licensing trusts, which McCabe finds unnecessary given the consolidation of NHS England's role.
• The statement addresses clauses 39 to 41 and Schedule 7 of the Health and Care Bill.
• Clauses related to NHS trusts are discussed in detail.
• Foundation trusts do not mean a two-tier NHS system; options remain for their formation without compulsion.
• Clause 43 places a new duty on English NHS trusts.
• Clause 57 places a new duty on NHS foundation trusts.
• The triple aim focuses on health and wellbeing of people, quality of services provided, and sustainable use of resources.
• The Bill adopts an evolutionary approach to integrating services between the NHS and local authorities.
• Local government systems and social care have a different evolution compared with the NHS, which was established in 1948 as a national system.
• Measures such as Integrated Care Boards (ICBs) and partnerships aim to facilitate better collaboration while respecting distinct accountabilities.