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NHS White Paper (Supporting Information)

Volume 514: debated on Monday 26 July 2010

Today I am publishing two further supporting documents to the national health service White Paper, “Equity and Excellence: Liberating the NHS” (Cm 7881) which was published on 12 July.

The first document, “Regulating Healthcare Providers”, provides further detail on the principles of the policies set out in the White Paper, and seeks views from the public and external partners on some of the questions arising out of them.

The White Paper set out a vision for a national health service centred around the needs of patients, focusing consistently on improving quality of care. One of the fundamental features of the proposals is to free providers from political interference and to establish a stable, transparent regulatory environment.

“Regulating Healthcare Providers” therefore sets out proposals to free providers from central Government controls and to develop Monitor, the current regulator for foundation trusts, as an independent economic regulator for health and adult social care.

Under our proposals, all remaining NHS trusts will become or be part of a foundation trust, free from the state’s operational control and not subject to the Secretary of State’s direction. We will create an environment where staff and organisations enjoy greater freedom and clearer incentives to flourish. All providers should be able to compete on a fair playing field, so that they succeed or fail according to the quality of care for patients and the value they offer the taxpayer.

Monitor will be responsible for regulating all providers to promote efficient, financially sustainable service provision. It will operate independently of Government so that providers have confidence in a stable, rules-based system—without the risk of political interference—to make long-term investments in services. Monitor will have powers to license providers of NHS services and core functions to regulate prices for NHS services, where needed, to promote competition, and to support service continuity.

The document seeks views on a number of questions by 11 October.

Today, I am also publishing the report of the Department’s review of its arm’s-length bodies.

The publication, sets out our proposals for arm's-length bodies in the health and social care sector. These proposals form part of the cross-Government strategy to increase accountability and transparency, and to reduce the number and cost of quangos.

The Government’s proposed reforms of the NHS, set out in “Equity and Excellence: Liberating the NHS”, will establish more autonomous institutions, with greater freedoms, clear duties and transparency in their responsibilities to patients. Power will be devolved to the front-line. Liberating the NHS will fundamentally change the role of the Department and those bodies accountable to it. Changes to the arm’s-length body sector must reflect these wider reforms.

There is also an economic imperative for change. The Government have guaranteed that spending on health will increase in real terms in every year of this Parliament and are committed to increasing the proportion of resource available for front-line services, to meet the current financial challenges and the future costs of demographic and technological change. This means that we need to make significant cuts in the costs of health bureaucracy. Over the next four years, the Government will reduce NHS administrative costs by more than 45%, freeing up resources for front-line care.

The review has assessed arm’s-length bodies in light of both the current financial challenges and the strategy for the NHS set out in “Equity and excellence: Liberating the NHS”. Only those functions which need to be carried out a national level to support the Department’s clear objectives should remain in the sector. Functions that are better delivered by other parts of the system should be devolved to the right level, and organisations that carry out these functions should be abolished. Shifting functions from public bodies back into the Department, or to those who are closer to local needs and are independent of the state, will ensure more direct accountability to local people, Parliament and Ministers.

By ensuring that functions are delivered in the right place, the sector will be streamlined to cut costs and remove duplication and unnecessary burdens on the front line. The review will achieve a significant reduction in the number and cost of public bodies.

The Department will impose tight governance and accountability over the cost and scope of its remaining arm’s-length bodies. In future, arm’s-length bodies’ independence will be exercised within the confines of clear and agreed functions. This is in line with the Government’s wider commitment to increase transparency and accountability.

The report details the proposals for each of the Department’s bodies. Where changes require primary legislation, these will be enacted through legislation which will be introduced in this Parliament.

Proposals for the General Social Care Council (GSCC), the regulatory body for social workers, are included in the report. My predecessor issued a written ministerial statement on 4 November 2009, Official Report, column 41WS about the publication of the Council for Healthcare Regulatory Excellence’s (CHRE) report and recommendations on the General Social Care Council (GSCC) function relating to conduct. As part of its response to CHRE’s report the previous Administration announced that the GSCC would report on its progress to Ministers at the end of March. This report has now been received and is published today.

While the GSCC has made good progress over preceding months, the reality is that the costs of maintaining an independent regulator for social workers are prohibitive and we therefore propose to transfer the function of regulating social workers to the Health Professions Council, which will accordingly be renamed to reflect its remit.

These publications will be of interest to anyone working in the health and social care sector, to taxpayers, and to people who use health and social care services.

Copies of today’s publications have been placed in the Library and copies are available to hon. Members from the Vote Office.

“Regulating Healthcare Providers” can be viewed at:

The report of the arm’s length bodies review can be viewed at: