Plans to rescue the NHS are in “chaos” after a weakened Theresa May backed down from a fight with MPs likely to involve hospital closures, Labour has alleged.
Legislation to allow local health chiefs to transform the delivery of care – and, crucially, save many billions of pounds – has been shelved after the Conservatives lost their Commons majority.
Health Secretary Jeremy Hunt has admitted the legal shake-up cannot go ahead without a “consensus” and that it will not happen while the Government is fixated on Brexit.
Two thirds of the 44 Sustainability and Transformation Plans (STPs) propose closing a hospital, or moving treatment to a different site.
The STPs have not been stopped in their tracks. Local health bodies will continue to create them, but without any legal underpinning.
Now it is feared that, without that legal footing, it will be significantly harder to compel the many different parts of the NHS to force through unpopular changes.
There have already been protests that the blueprints lack the “democratic legitimacy” they require to win public support, partly because they do not fully involve local authorities.
The Nuffield Trust health charity warned the much-needed transformation of the NHS – shifting treatments to more modern, community facilities – would now be “harder, slower and messier”.
Its chief executive, Nigel Edwards, said: “This will disturb the timetable of what’s being proposed and whether they can produce the savings wanted in the time available. There will be legal knots to work through.”
The NHS Confederation, which brings together hundreds of health bodies, said an extra £2bn a year was needed to make a success of STPs, with the NHS “struggling to cope with demand”.
And Jonathan Ashworth, Labour’s shadow Health Secretary, said: “The Government’s transformation plans for the NHS are in total chaos.
“The whole process has been shrouded in secrecy and has clearly lost the trust of the public. Now we’re told the necessary legislation to help local health providers work closer together won’t be ready until after Brexit.”
Although stepping back from hospital closures may be popular, Mr Hunt is relying on forcing through integration to achieve the bulk of £22bn of “efficiencies” demanded from the NHS.
Without them, it will be far harder to avoid cuts to services – or to lift the cap on NHS pay, which many Tory MPs are urging the Prime Minister to do urgently.
The STP blueprints have already been unveiled, involving the closure of expensive, outdated buildings in order to join up care better and bring delivery closer to patients.
The shelving of the necessary legislation was revealed when the Queen’s Speech – for the next two years, through to 2019 – was published with no bills for front-line health or education services.
Mr Hunt himself told the NHS Confederation: “We said [in our manifesto] that we would legislate to give STPs a statutory underpinning if that was felt to be necessary.
“But obviously, the legislative landscape has changed, and that means that legislation of this nature is only going to be possible if there is a consensus across all political parties that it’s necessary.
“I don’t think that is in any way impossible, but it’s realistically not something we would do while the Brexit process was carrying on.”
Mr Hunt has already been criticised for raiding capital budgets to pay for day-to-day NHS spending, starving the STPs of funds and undermining their work.
At the election, Labour was criticised in some quarters for demanding a moratorium on changes planned in the STPs – even when there was a consensus they were badly needed.
Mr Ashworth added: “Jeremy Hunt has been totally unclear about which local plans are going ahead and which will be redrawn. Patients and the public deserve better. The Government should review their plans for the NHS.”
But a Whitehall source said: “Unlike Labour, we are supporting the NHS and social care services to join together and improve patient care through STPs.
“Respected independent figures like the King’s Fund have endorsed these plans – and we’ll shortly be outlining the details of millions of pounds of additional funding for them.”
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