My Political Wish for Friday, the Repeal of the Health and Social Care Act 2012

The Health and Social Care Act has failed and needs to be replaced. Unfortunately it has failed on so many levels that to effectively modify it would mean ripping it apart and starting again.

Its focus was all local with no strategic control; we saw the effects of this with last year’s winter crisis in A&E Departments (Which actually was a failure in healthcare across the broad and especially in social care). The “Better Care Fund” has taken millions out of Primary Care funding to pay for short falls in Social Care funding. Private companies have not produced any benefits when they have taken over running NHS services. Hinchingbrooke wasn’t the only time a private company “handed back” an NHS contract. Also, the Kings Fund has stated that private healthcare companies are more expensive to run; NHS spends 5-6% on administration where private companies spend 15-30%.

As a Community Nurse, I have not seen any of the promised benefits of the Health and Social Care Act, though our workload has increased as the number of patients we care for has increased (This has been seen right across the NHS).

Whatever replaces it needs to both meet the needs of local communities but also needs to have a strategic control; otherwise we will repeat what happened last winter. It also needs to bring Social Care back under the control of the NHS, because at the moment there are too many agencies involved in it and too many gaps between them.

Whatever replaces it needs to be well funded, not cooking the books with “efficiency savings” budgeted in. Healthcare costs are rising faster than inflation (Look at the price of medications) and the number of patients needing treatment is also raising. A measly 1% increase is actually cutting healthcare funding in real terms (The coalition government has imposed 4% cuts to NHS funding year-on-year, even with promises to “Ring fence front-line services”).

Whatever replaces it needs to be legally sound. Over the years both the Conservatives and Labour have opened up the NHS to private tenders and contracts, this has brought the NHS under UK and EU competition laws. Repealing Health and Social Care Act maybe a legal nightmare and companies already with NHS contracts may demand millions in compensation.

Also, healthcare professionals, healthcare managers and patients need to be consulted about what replaces the Health and Social Care Act, it should not just be the idea of economists and politicians (as has happened all too often in the past). the Health and Social Care Act came as a shock to NHS staff and patients alike, it’s replacement should not.

Andy Burnham is talking a lot about “integration” in healthcare, but who is he listening to?

(This blog was originally written as part of the Nursing Standard’s Readers Panel, and appeared in an edited version in that section)

Drew