Your article (If you believe in a public NHS, the new health and care bill should set off alarm bells, 7 December) addresses an important piece of legislation about which there are very real concerns. Several key arguments made in it, however, are incorrect.
The authors write that “new integrated care boards … won’t serve all people living in a local area, but a ‘group of people’ who can be drawn from anywhere in England”. This is wholly wrong. These new NHS administrative units will serve 42 areas of England already set out by NHS England. The second clause of the chapter dealing with integrated care boards states that each one is to be established “for an area within England”, which may not overlap with other areas. Readers in Cornwall are not about to discover next April that they are under the care of NHS Lincolnshire.
The article also suggests that the bill “removes the requirement for emergency services to be provided for everybody present in an area”. In reality, it expressly directs the new boards to arrange to meet people’s needs for medical services, ambulances, nursing services and “such other services or facilities as are required for the diagnosis and treatment of illness”. Any board which tried to stop providing all emergency care would swiftly find itself in court.
This bill requires serious and urgent scrutiny: it pares back the generosity of the planned social care cap, and introduces dramatic new powers for politicians to intervene in the NHS. There is not long left for meaningful changes to be made, as it has already passed the Commons. The right questions will not be asked if basic points of the legislation are misunderstood.
Helen Buckingham
Director of strategy, Nuffield Trust
Mark Dayan
Head of public affairs, Nuffield Trust
