Extra powers for the health secretary under new NHS reform plans could open the door to more politicisation of the NHS, MPs have warned.
The Commons health select committee said the planned new powers that would be granted to Matt Hancock under proposed changes legislation lack the necessary safeguards or detail on how the powers would be used.
The committee demanded more transparency over the power of the secretary of state to appoint senior NHS managers, the ability of ministers to intervene in local reconfigurations and service closures and the power to change the role of national organisations without primary legislation.
The government has said the planned reforms, which will be the first major change to the NHS in more than a decade, will help local NHS services to join up with local councils, social care and other services.
It will create new integrated care organisations which will aim to deliver services for people across regions.
But the proposed legislation, which was confirmed in the Queen’s Speech this week, include a host of so-called Henry VIII powers that the health secretary will be able to use without needing a vote in the House of Commons.
NHS Providers chief executive Chris Hopson, who represents the views of NHS trusts, said: “Trust leaders are pleased to see the committee share their concerns over proposals in the white paper to give extensive new powers to the secretary of state. We wholeheartedly support the committee’s recommendation that further safeguards are put in place to protect the NHS’s operational independence and to ensure the power to intervene in local health services does not lead to the politicisation of the NHS.
“It is inappropriate for party politicians to be able to solely determine how NHS funds are allocated across each region and constituency and which NHS managers should be hired and fired. They should not also be able to stop much needed changes to improve the quality and safety of local health services without good reason.”
The committee also criticised the current lack of ambition on solving the workforce crisis in the NHS caused by widespread vacancies for nurses, doctors and other staff.
The new health bill requires the government to publish updates on workforce planning once every five years.
The MPs said this was not an “adequate response” and ministers should include a requirement to publish annual reports on workforce shortages and future staffing requirements that cover the next five, 10 and 20 years, together with an assessment of whether enough staff are being trained.
The cross-party group of MPs also warned the government it would be “extremely disappointed” if Boris Johnson fails to deliver on his promise to produce a long-term plan for social care by the end of the year.
It said the lack of a plan could undermine the ambitions for the NHS and the new Health and Care Bill should include a duty to publish a 10-year plan for social care within six months of the bill become law.
Mr Johnson, originally promised to “fix” the system when he entered No 10 in July 2019, but the government has only promised to bring forward proposals “later in the year”.
In its report, the committee said: “The absence of a fully funded plan for social care has the potential to destabilise integrated care systems and undermine their success.
“Without secure, long-term funding, the problems that have bedevilled the care sector over the last two decades will not be solved.”
The committee chairman, former health secretary Jeremy Hunt, said: “If such issues are addressed, the government has an opportunity to deliver a post-pandemic watershed 1948 moment for the health and care system, matching the significance of the year the NHS was founded.
“But if they are not, it will be a wasted opportunity to deliver the truly integrated care required by an aging population.”
