Boris Johnson to seize control over NHS with new law

Ministers want new powers to instruct health bosses to force pace of change, amid fears that private-sector involvement could be expanded across health service

Andrew Woodcock
Political Editor
Saturday 08 February 2020 11:57 GMT
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Jeremy Corbyn challenges Boris Johnson on the NHS

Boris Johnson is planning to use new health legislation to impose ministerial control over the NHS.

A bill to be introduced this year will contain new powers for ministers, including Mr Johnson, to issue instructions to NHS England’s chief executive, Sir Simon Stevens.

The move, which is understood to have been developed over the past year by the health secretary, Matt Hancock, is likely to raise concerns that Conservative ministers could seek to use new powers to extend private-sector involvement in the NHS.

Under the current terms, Sir Simon’s position is operationally independent, but the prime minister is said to be concerned that this arrangement makes it difficult for Downing Street to force through changes to the system.

NHS England was created in 2013 under then health secretary Andrew Lansley as part of a widely criticised shake-up that controversially introduced an internal market system. Stevens wants to develop an integrated care system across England, with the ability to plan collectively.

NHS England’s separation from the Department of Health was designed to keep it at arm’s length from ministers, allowing them to avoid direct blame for poor performance.

However, it is understood that Mr Johnson is concerned this gives Sir Simon too much freedom and prevents No 10 from stepping up the pace of reform.

Ministers have begun monthly meetings with Sir Simon to demand reductions in waiting times, which hit their worst-ever levels in A&E departments in December last year.

Mr Johnson is understood to want “more levers to pull” as he attempts to deliver on election promises of improvements to the health service.

Plans for more ministerial control are expected to form part of a wider overhaul of NHS structures, establishing legally independent “local care groups” of hospitals and clinics.

The Queen’s Speech in December promised legislation to “accelerate” the delivery of the 10-year NHS long-term plan to “transform” patient care and “future-proof” the health service.

The Times obtained a government briefing note on the changes, which said: “The proposals NHS England brought forward were designed in a different parliament than the one we have now, with an underlying principle to avoid an extensive reorganisation.

“As a result, while they would entail a shift away from the market model enshrined by the 2012 Act towards a much more managed system, they do not deliver the fundamental reform of the 2012 Act that we and the system believe will be needed.”

Downing Street declined to comment on the report.

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