COMMENT
Ingrid Saffin, head of healthcare at law firm Mundays, and her colleague Phil Walton, examine the legislative progress so far of the Health & Social Care Bill, and its future impact on finance and governance.
T
he Health & Social Care Bill continues to progress slowly yet steadily through
Parliament. As things presently stand, it has been through two readings in the House of Commons and completed its commit- tee stage in the House of Commons on 31 March 2011. Some of the content of the Bill and the speed with which it was progressing through Parliament caused serious concern to certain groups involved in healthcare in the UK. The perceived failure of the Gov- ernment to take seriously these concerns led to a number of pressure groups lobby- ing fiercely and very publicly. It looked as though the Bill might be doomed.
In response to this, the Government
announced in April that there would be a break in proceedings to “pause, listen and reflect”. Professor Steve Field, a practising GP, chaired the NHS Future Forum, an independent group whose task was to make recommendations to the Government. 29,000 people provided views to the Future Forum and 16 key recommendations were made to the Government.
In the light of the recommendations and in a highly unusual step for legislation in the UK, the Bill was sent back to the Pub- lic Bill Committee for further scrutiny. The Committee had 12 sittings to debate the Bill and its consideration of the Bill finished on Thursday 14 July 2011.
The Bill’s next stopping point had been identified as being the Report stage, which was scheduled to take place on 6 Septem- ber 2011.
However, health secretary Andrew Lansley launched the second phase of the Govern- ment’s “listening exercise” on 18 August 2011, with Professor Field once again being responsible for presenting a summary of findings to ministers.
This unprecedented step demonstrates the uncertainty that surrounds the Bill in its current form. Indications from the Gov- ernment suggest that the latest phase of the listening exercise will conclude later this year with the exercise taking “months rather than weeks”.
Although the Bill and the proposed NHS re- forms appear to be in a beleaguered state,
20 | national health executive Sep/Oct 11
the Bill still remains likely to progress through the Commons and the Lords and eventually become law. However, the form and impact of the Bill remain uncertain.
The impact of the Bill
The Bill will be just one part of the over- all picture. As and when it becomes law, many regulations will be issued which will put flesh on the bones of what is essentially an “enabling Act”. At each stage of the pro- cess, greater clarity will be achieved and it will be interesting to see how this develops.
Strategic Health Authorities are likely to re- main in their statutory roles for the whole of 2012/13 and, subject to the passage of the Bill, will be abolished alongside Pri- mary Care Trusts at the end of March 2013.
Under current plans, the NHS Commis- sioning Board and the other new national bodies will take up their full responsibili- ties from 1 April 2013.
By April 2013, subject to the passage of the Bill, all GP practices will be members of a commissioning group. This is notwith- standing the BMA’s statement of 20th July 2011 confirming that it will continue to call for the Bill to be withdrawn, whilst still “critically engaging with the government to achieve necessary improvements”.
Ingrid Saffin
The Bill, in its current form, makes provi- sion for a staff transfer scheme in connec- tion with the merger, dissolution or varia- tion of Clinical Commissioning Groups. In-
Phil Walton FOR MORE INFORMATION
T: 01932 590 535 E:
ingrid.saffin@
mundays.co.uk W:
www.mundays.co.uk
© Jim Trodel
terestingly, it makes no overt reference to a staff transfer scheme from a PCT to a CCG, so it is unclear if the staff transfer scheme provisions apply in that specific case.
In practice, TUPE would in all likelihood apply on a transfer of functions from a PCT to a CCG and therefore the majority of PCT employees, where their tasks are transfer- ring to a CCG, would transfer on the same terms and conditions.
The staff transfer schemes proposed by the Bill do allow additional rights and liabilities that would not otherwise be transferred to be transferred, as well as criminal liabilities. A staff transfer scheme may also create or impose rights, as well as make provision regarding the continuation of current legal proceedings.
Like it or not, changes are coming. De- pending on how they are met by healthcare professionals, they could be the best thing to happen to the NHS for decades or they could be the worst.
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