Petition Renationalise the NHS, scrap integrated care systems, and end PFI contracts

Government responded

This response was given on 23 December 2021

The government has been steadfast in its commitment to the guiding principles of the NHS which mean the NHS is not and never will be for sale to the private sector.

This government has no intention of privatising the NHS.

We firmly refute the claim that the Health and Care Bill undermines access to care or universal standards. It is not a privatising Bill. It delivers on the NHS’s own proposals for reform in its 2019 Long Term Plan and makes permanent some of the innovations we have seen in the system due to Covid. It captures learning from the response to the pandemic and the vaccine rollout. And it goes even further, improving access and standards with a range of measures to level-up health outcomes across the country, enabling people to live longer and healthier lives.

The Bill establishes Integrated Care Boards (ICBs) to take on the commissioning functions of existing CCGs and some of NHS England’s commissioning functions. They will be directly accountable for NHS spend and performance, and will be NHS bodies. They will bring in representatives from a range of other NHS bodies including NHS commissioners and NHS providers. The work of ICBs will be driven by health outcomes, with no space for profit, competition, or private interests.

The new commissioning bodies being set up are all public bodies and will not, indeed cannot, be controlled by private providers. Independent providers, as corporate entities, will not be able to sit on Integrated Care Boards, nor will any individual appointed there be a representative of such an interest in any capacity.

The Bill includes ample safeguards to ensure that the interests of the public and the NHS are always put first. The ICB chair has the power to veto members of the board if they are unsuitable, and NHS England has the power to issue guidance to ICBs in relation to appointments as part of its general guidance-making power. That sits alongside the robust requirements on ICBs to manage conflicts of interests, including publishing and maintaining a register of Members’ interests, and NHSE’s wider duty to issue guidance to ICBs.

At Report Stage the Government further clarified, by amendment, existing provisions that ensured private sector organisations would not be able to sit on ICBs.

It is the view not just of this Government but of the NHS that local commissioners are the best people to determine what services a local population needs. Commissioners will continue to be responsible for managing contracts to ensure services are arranged with all providers, including those with the independent sector, to provide high quality of care at efficient prices.

In line with NHS recommendations on competition and procurement rules, we are changing the way the NHS arranges healthcare services in a way that provides more flexibility, reduces bureaucracy for both commissioners and providers and reduces the need for competitive tendering where it adds limited or no value.

The vast majority of NHS care has and will continue to be provided by public sector organisations. However, successive Governments of all political affiliations have allowed the NHS to commission services from the private and voluntary sector. Whether that is to improve accessibility and experience for patients, to increase capacity quickly, or to introduce innovation. NHS commissioners may commission services to meet the needs of their local area from any CQC-registered provider, regardless of their corporate status, provided they follow procurement rules and regulations.

NHS England will remain accountable to the Secretary of State and Parliament. The Health Secretary has duties, including to the continuous improvement of quality of services, and to the NHS constitution, which as one of its guiding principles has that NHS services are free of charge, except in limited circumstances when sanctioned by Parliament. Access to NHS services continues to be based on clinical need, not an individual’s ability to pay.

The NHS is and always will be free at the point of use. The government has been steadfast in its commitment to the guiding principles of the NHS which mean the NHS is not and never will be for sale to the private sector.

Department of Health and Social Care