The government has tabled a series of amendments to the Health and Social Care Bill in advance of its Report Stage in the House of Lords, which begins next week.
Health minister Earl Howe has tabled a number of amendments in a bid to placate concerns raised by the House of Lords.
Chief among them is a clearer directive to both clinical commissioning groups and the health secretary to promote a ‘comprehensive health service’, following fears that CCGs could ration some services.
Clauses have also been inserted requiring CCGs to give clearer evidence on how they are tackling health inequalities and promoting education and training, and to diminish the potential for conflicts of interest.
It comes in the week when the Royal College of Psychiatrists joined the Royal College of Radiologists in opposing the Bill in its current form. A survey of psychiatrists finds that 85% believe the Bill will have a negative impact on the health and social care system, and 80% consider it to be fundamentally flawed.
Other amendments include bestowing the health regulator Monitor with the power to require healthcare providers to promote integration of NHS services; a new duty on the health secretary, NHS Commissioning Board and CCGs to report annually on their progress in tackling health inequalities; and duties on CCGs and the NHS Commissioning Board to promote patient involvement in their own care.
Health secretary Andrew Lansley said: “The principles of our modernisation plans – ‘no decision about me, without me’ for patients, clinical leadership with doctors and nurses leading discussions on services, a focus on results for patients and reducing bureaucracy – have always been at the core of the Bill. These principles are widely accepted as reported by the independent NHS Future Forum. But we have been carefully listening to the ideas raised as the Bill has progressed through Parliament. And as a result we have today tabled a series of amendments to address these remaining issues.”
Report stage in the House of Lords is due to start on 8 February. The BMA and the royal colleges are yet to respond.
Professor Sue Bailey, president of the Royal College of Psychiatrists, said: “On behalf of our members and patients, we will scrutinise these amendments carefully in order to make an informed decision on whether or not they address the very real concerns of psychiatrists.”
The college wants the Bill to ensure parity of esteem between mental health and physical health; a reduction rather than an increase in health inequalities; that integrated care is safeguarded over competition; that competition is only used in the NHS where it can be shown to clearly benefit patients; and, continuation of a system of effective postgraduate medical education and training.