Overview

This bill aims to restructure the National Health Service (NHS) in England, clarifying the Secretary of State's responsibilities, establishing Integrated Health Boards, ending private finance initiatives (PFIs), and excluding the NHS from international trade agreements. It also abolishes the Immigration Health Charge.

Description

The bill significantly alters the NHS's governance and structure. Key changes include:

• Secretary of State's Duties: Reinforces the Secretary of State's duty to provide a comprehensive, integrated health service, free at the point of use except where explicitly charged by law.
• Integrated Health Boards (IHBs): Creates Strategic and Local IHBs to manage NHS services regionally and locally, responsible for service provision and integration with social care. These boards will replace NHS England and Clinical Commissioning Groups (CCGs).
• Abolition of Existing Bodies: NHS England, CCGs, NHS trusts, and NHS foundation trusts are abolished and their functions transferred to IHBs or the Secretary of State.
• Private Finance Initiatives (PFIs): Mandates the Treasury to minimize and ideally end PFI expenditure in the NHS, with a report due by December 2019 outlining plans.
• Trade Agreements: Prohibits the inclusion of the NHS in international trade agreements or treaties.
• Immigration Health Charge: Repeals the Immigration Health Charge.
• National Terms and Conditions: Establishes a duty for the Secretary of State to negotiate with trade unions to create joint machinery for collective bargaining on NHS workers' terms and conditions.
• Community Health Councils: Requires the establishment of Community Health Councils to represent public interests.

Government Spending

The bill will likely lead to increased government spending in the short term due to the assumption of PFI liabilities by the Treasury. The long-term financial impact is uncertain and will depend on the effectiveness of the new IHB structure and the success of efforts to reduce costs.

Groups Affected

• Secretary of State for Health and Social Care: Increased responsibilities and direct oversight of NHS service provision.
• NHS Staff: Potential changes to employment terms and conditions through collective bargaining.
• Patients: May experience changes in service delivery and access due to the restructuring of the NHS.
• Local Authorities: Increased collaboration with IHBs on social care integration.
• Private Sector Companies Involved in PFIs: Potential loss of revenue and contracts.
• Immigrants: Abolition of the Immigration Health Charge will remove a financial barrier to accessing NHS services.

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