Statement on the Government’s proposed NHS reforms


Monday 08 February 2021

“It may be that the social history of Britain will record that a lasting and substantive achievement of Brexit has been to return to the British people the NHS that was brought in by Aneurin Bevan and was very nearly destroyed by the Conservative/Liberal coalition supporting the outrageous and damaging Andrew Lansley legislation in 2012.

As always the devil will be in the detail and Parliament will have to examine very carefully the wording of this legislation. Above all, it must avoid one overall vesting day when everything changes.  The NHS is too fragile for any such reorganisation.  The legislation needs to give the Secretary of State powers to implement in stages.  We must also not go back to regions.  Hospitals must return to being answerable to their geographical catchment areas, but room must be left for vesting health in the successful new Mayoral governance.  However, immediate action is also needed in some areas.  The Leicester reorganisation, where a decision is pending by the Chief Executive, should be stopped in its tracks.

But the big achievement is to return the NHS to the original version of  the final decision-maker being the Secretary of State for Health in England.  People will argue how well the coordination has worked between England, Scotland, Wales and Northern Ireland during the pandemic.  My personal opinion is far better than I would have expected given the obvious political undertones of separation.  It is only when the full financial underwriting of the pandemic is revealed in the Inquiry, that has been promised, that the Scottish people will have to ask themselves a very fundamental question.  Could Scotland alone have financed, let alone brought together, the armoury of extra measures and new drugs and vaccines.  The question will, of course, be evaded but the true answer is an emphatic ‘no’.

For those who supported the Health and Social Care Act 2012 the pandemic was a legislative Armageddon. Very quickly Matt Hancock had to brush aside the legislative curbs and take democratic control and in the process sweep aside the Chief Executive of NHS England. Simon Stevens’s voice boasting about 98% bed occupancy will never be heard again. It was a folly to believe that the NHS was just a business and that hospitals and other parts of the NHS did not need the resilience of spare capacity.

The deep issue of this pandemic has also revealed how successive governments have neglected public health.  Jeremy Hunt was in charge of responding to the lessons of the 2016 Cygnus exercise, the results of which were never published at the time.  In December 2016 the Chief Medical Officer, Sally Davies, at an international conference, said that as a result of the trial exercise on an influenza pandemic “it became clear that we could not cope with the excess bodies” and faced the threat of “inadequate ventilation.”  The real NHS – the one we had from 1948-2013 – would have acted on that warning.”