Published in July, Equity and Excellence : liberating the NHS looks towards an NHS in England – that is slimmed down, smartened up and democratised to deliver better quality care. Out goes what remains of Aneurin Bevan’s nationalised vision, and out too is the New Labour Government’s regime of process targets, replacing them with outcomes measures.
There will be a new role for Local Authorities to facilitate closer working between health and social care services, to support patient choice, to improve public health and enhance commissioning.
The White Paper spells out Government plans to make the NHS more competitive, with NHS Providers being more accountable and transparent.
England’s 35,000 GPs will have control of about £70bn. Clustered in GP Consortia, they are to be given freedom and responsibility for buying care from Providers, within and outside the NHS. GPs will be unable to generate a surplus. And should they fail, they will not be personally liable.
While Monitor superintends NHS Foundation Trusts at the moment, the White Paper proposes to turn Monitor into a full-blown economic regulator to oversee a healthcare market in the same way that Ofcom and Ofgem oversee the markets in communications and energy.
Consideration will be given to abolishing the cap on private income that NHS Foundation Trusts can earn and whether any surplus can be re-invested in the organisation, although they will not be privatised.
While GPs may find sufficient power to shelter from the full impact of competition, Liberating the NHS challenges doctors too. Patients will get more choice and control. This will be backed by an information revolution to involve Patients in their care, designed around them and achieving, in Mr Lansley’s words, No decisions about me, without me.
March 2014 is an important milestone for NHS Trusts – they will be or have become part of, an NHS Foundation Trust. They will be subject to regulation from Monitor, and will be given new freedoms as part of the largest and most vibrant social enterprise sector in the world.
The Secretary for State will hold the NHS Commissioning Board to account for delivering better health outcomes through a national NHS Outcomes Framework.