The Royal College of Physicians (RCP) has issued a briefing to Peers in the House of Lords on the Health and Care Bill ahead of second reading on 7 December 2021.
The Health and Social Care Bill completed its passage through the House of Commons on 23 November 2021. It now moves to the House of Lords for further scrutiny as part of its legislative journey.
The second reading in the Lords is the first opportunity for Peers to consider the general principles of the bill and areas where it could be strengthened.
Throughout the Commons stages, the RCP has been one of 70 health and care organisations calling for provisions on workforce planning to be significantly strengthened, culminating in a vote on an amendment pushed by the Rt. Hon. Jeremy Hunt MP at report stage on 23 November. The amendment tabled by Hunt for the secretary of state to have to publish regular assessments and future workforce numbers was unfortunately rejected by MPs at 219 to 280 votes.
The bill now goes to the House of Lords, where Peers will have the opportunity to debate its contents and suggest amendments.
The RCP continues to believe that the bill must be strengthened in several areas, most notably on workforce, health inequalities and research. The RCP is calling for:
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Greater accountability and transparency on workforce numbers. The provisions on workforce planning must be strengthened so that the secretary of state for health and social care must have a duty to publish projection data on current and future workforce numbers every 2 years so we understand how many health and care workers are needed to meet patient demand now and in future to meet demand. 70 health and care organisations support the bill being amended to this effect.
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The triple aim should be amended to explicitly reference health inequalities. Making health inequalities an explicit part of the triple aim would mean the impact of decisions on health inequalities would need to be considered by NHS England (NHSE), Integrated Care Boards (ICBs) and Trusts.
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The bill should give NHS England a statutory duty to publish guidance for NHS bodies on collecting, analysing, reporting and publishing data on factors or indicators relevant to health inequalities.
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The ‘duties as reducing inequalities’ should also be amended to include a requirement for ICBs to set up systems to identify and monitor inequalities in health between different groups of people within the population of its area. The existing duty will only be effective if systems can identify where local inequalities exist and monitor any changes to them.
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Following the success of the COVID-19 vaccine, the bill is also an opportunity to prioritise clinical research and cement the UK’s place as a global leader in that space. The current duty for ICBs to promote research should be strengthened so that the bodies for which ICBs are responsible have a duty to ‘conduct’ research.