A major loss of local accountability and control, coupled with a massive expansion of centralised powers, and the danger of a new wave of lucrative NHS contracts to be awarded without competition are among the main features of the government’s controversial Health and Care Bill to drive another major top-down reorganisation of the NHS.
Fewer local bodies, less local voice
The Bill would abolish local Clinical Commissioning Groups, 207 of which were established back in 2012-13, with 106 still functioning in April 2021, and reduce “local” control over the NHS in England to just 42 “Integrated Care Systems” (ICSs), some of which would cover very wide areas, and populations of up to 3.2 million.
In preparation for this, CCGs in many parts of the country have already been systematically merged into bigger, less accountable and more unwieldy bodies, leaving only the hollow pretence of local voice for local communities and council scrutiny committees, while decisions are taken by new, remote bodies with little or no concern for local health needs and inequalities.
ICSs would consolidate these mergers, leaving the NHS with less local accountability and fewer “local” bodies deciding policy than any time in the last 50 years.
Full story in The Lowdown, 9 July 2021