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All spin and no substance in Tories' health and social-care plan, Unions and NHS campaigners warn

MUCH-TRUMPETED government reforms to health and social care are actually just a top-down reorganisation that could speed up privatisation, unions and NHS campaigners warned today.

Tory ministers spent much of this week spinning their white paper as an attack on bureaucracy, a helping hand towards long-awaited integration of health and social care services — and even as an end to privatisation.

Health Secretary Matt Hancock said the proposals would help integrate the NHS, social care and local government while getting support “closer to the front line.”

But unions said his proposals, published today, failed to address basic issues of adequate funding, the practicalities of integration or the huge damage done by previous Tory reforms and years of privatisation.

And campaigners warned that the plans would weaken what remains of democratic accountability in the NHS while facilitating even greater private-sector involvement.

The Unite union said there was “too much rhetoric from Health Secretary Matt Hancock on tackling bureaucracy” and not enough detail on how integration would actually happen.

The Tories’ last disastrous NHS reform in 2012 gave “too much sway to the profit-hungry private sector,” which the current proposals would not remove, said Unite national officer Jackie Williams.

Ms Williams said Unite supported removal of a Health and Social Care Act 2012 provision that placed NHS commissioning under EU procurement legislation.

“But we have little faith ministers have lost their obsession with outsourcing health services, despite the private sector’s abject failure over the ‘test and trace’ programme roll-out and the fiasco of how the PPE contracts were awarded.”

The GMB union described the failure to address the need to reform social care as “the hole at the heart of the health and social-care white paper.”

The Prime Minister had promised to “fix” social care within 12 months of being elected, noted GMB national secretary Rehana Azam, adding: “They couldn’t keep that promise 18 months ago — why should GMB members trust them now?

Unison head of health Sara Gorton said: “Scaling back the damaging internal market that forces the NHS to compete against itself and the private sector can’t happen soon enough.

“Today’s proposals are at least an admission they got that wrong and the start of a process to undo their costly mistakes.

“But the most disappointing element is what’s missing. The pandemic has laid bare the extent of the social care crisis, yet the sector must now wait many more months before it receives government attention.”

The Keep Our NHS Public campaign also expressed disappointment that only part of the Act was to be repealed, leaving a division between NHS commissioners holding the budgets and providers delivering care to patients.

“This is another massive top-down reorganisation which retains the fragmentation and chaos of outsourcing, but threatens to strip away the ‘bureaucracy’ of competitive tendering,” said campaign secretary Dr John Lister.

That, said Dr Lister, would leave “huge contracts to be allocated without any competition or accountability — as we have seen in the disastrous cronyism and shambles of the Covid contracts for PPE and test and trace.”

Shadow health secretary Jon Ashworth also challenged the idea that the reforms would see less privatisation.

The requirement for competitive tendering might be removed, said Mr Ashworth, “but contracts can still go out to the private sector and as far as we can tell the contracts that have gone out, there’s no insistence that they should come back in.

“If you look at the detail of the reforms, it suggests that representatives of the private sector can actually sit on these new local care bodies and I think that’s the first time that’s happened in history.”


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