It proposes the abolition of NHS primary care trusts (PCTs) and Strategic Health Authorities (SHAs). Thereafter, £60 to £80 billion of “commissioning”, or health care funds, would be transferred from the abolished PCTs to several hundred “clinical commissioning groups”, partly run by the general practitioners (GPs) in England. A new public body, Public Health England, is planned to be established on 1 April 2013.
The proposals contained in the Act are some of the coalition government’s most controversial. Although many measures were included in the Conservative Manifesto, they were not discussed during the 2010 general election campaign and were not contained in the 11 May 2010 Conservative–Liberal Democrat coalition agreement, which mentioned the NHS only in reference to an annual real-term funding increase.
Within two months of the election a white paper was published, outlining what the Daily Telegraph called the “biggest revolution in the NHS since its foundation”. The bill was introduced in the House of Commons on 19 January 2011. In April 2011 the government announced a “listening exercise”, halting the Bill’s legislative progress until after the May local elections. The “listening exercise” finished by the end of that month.
Many commentators have emphasised the scale of the changes envisaged in the Act and its complexity, and have speculated on how slowly or quickly it will be implemented. Although media focus has been on the changes proposed in health services, there are also implications for the provision of social care e.g. for how social care will be more closely integrated with health care; for how the social work profession is regulated; how care provision is regulated by the Care Quality Commission; for how data on social care provision is collected and used by the Health and Social Care Information Centre.
Rescare will of course monitor the Act’s implementation, and especially the implications for persons with a learning disability and their families.