The Health and Social Care Bill was passed by the House of Commons yesterday with a government majority of 65. The bill was delayed earlier this year when it was put on hold due to mounting criticisms of the proposed reforms from all sides. But after a listening exercise, it was sent back to the Commons for revision, during which extensive amendments were made, a number of which involved the functions of the NHS Commissioning Board and clinical commissioning groups following recommendations from the NHS Future Forum.
The bill’s next destination is the House of Lords, where it is expected to spark intense debates. Whilst most feel that putting GP’s at the heart of commissioning is a good idea in theory, as GP’s have the most knowledge of their patients and their needs, and are therefore best placed to make commissioning decisions, many of the amendments made served to complicate rather than clarify the issues flagged up by various groups including 2020health. Another major point of contention is competition, and whether competition or co-operation amongst providers is the key to decreasing costs and increasing efficiency and provider responsiveness.
A major fear is that the confusing language and complicated amendments of the bill in its current form will only serve to increase bureaucracy and inefficiency. Hopefully, however, scrutiny by the House of Lords will help to streamline the bill and identify crucial gaps.