Workers' Weekly On-Line
Volume 51 Number 1, January 16, 2021 ARCHIVE HOME JBCENTRE SUBSCRIBE

Safeguarding the Future of the Health Service

A Wrong Direction for a System of Care

The government is swiftly moving towards legislating on a US-style Integrated Care Systems (ICS). This would give much more power for corporate decisions to be made away from local areas in favour of private consultancies and health companies, as well as closing hospital and community services.

NHS England has produced a document Integrated Care: next steps to build strong and effective integrated care systems across England, which they say details their vision for "a more effective and responsive care system across England". NHS England has been running a survey on the document proposals, which began on November 26, 2020, and which has just closed on January 8 [1]. They state: "This document sets out how NHS organisations, local councils, front-line professionals and others will join forces in an integrated care system (ICS) in every part of England from April 2021."

It is a moot point whether NHS England will now press ahead with the proposals and claim that patients, NHS staff, partner organisations and interested members of the public were consulted.

The NHS England plan would take decisions further away from the communities, placing these decisions even more firmly in the hands of those that have vested interests in the NHS, and directly profit from then. This anti-social direction would be imposed across whole regions.

Far from providing greater incentive for collaboration and making health authorities accountable, the incentive will be the same as in the present "internal market". In fact, it would make it easier for the big players to capture even bigger contracts, for public bodies to swallow up smaller hospitals and services, and for private ones to use this monopoly of the ICS to get real "rewards" at even less risk. These corporate decisions will be for their benefit and not of patients as we see increasingly in the present system.

To allow systems to shape their own governance arrangements will not sort out the mess that the NHS is in, but will compound it. It must be the responsibility of government to involve all the staff and their trade unions, all the communities of England as well as local authorities in providing a comprehensive, human-centred public health and social care system to meet the needs of all at the highest level. Private companies and consultancies and those supporting their interests should have no place in deciding on the future of the NHS. Neither should they be provided with public NHS data, patient data or any insider information on our NHS.

The proposal that services currently commissioned by NHS England should be either transferred or delegated to ICS bodies would mean less transparency for people to grasp what is occurring with their health services. Decisions would be made in the ICSs. The democracy that must be established in running the health services is one involving all the staff and their trade unions, all the communities of England as well as local authorities in providing a comprehensive, human-centred public health and social care system to meet the needs of all at the highest level in every area.

What is needed is a new direction where public authorities based on health staff, and on people in the communities they serve, are empowered to directly speak about their needs and participate in making the decisions. A human-centred system providing a universal and publicly-funded health and social care system which is free to all is the requirement of the times.

Survey:
1. https://www.engage.england.nhs.uk/survey/building-a-strong-integrated-care-system/


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