The government's controversial Health and Social Care Bill has finally been passed into law after gaining Royal Assent today (27 March).
The legislation - first published in the white paper Equity and Excellence: Liberating the NHS in July 2010 – will now be known as the Health and Social Care Act (2012). Peers in the House of Lords were successful in generating 374 amendments. The bill met the approval of MPs in the House of Commons last week and was voted through by a margin of 82 votes.
After being in parliament for almost 14 months with over 50 days worth of debates – the bill has had more scrutiny than any other bill in history. No wonder the government's health reforms caused its fair share of headlines.
Following criticism from the public, Royal College of GPs (RCGP)and the British Medical Association (BMA) over the use of the private sector in the NHS, the government engaged in an almost unprecedented 'listening exercise' on the 6 April 2011. Professor Steve Field was appointed Chair of the NHS Future Forum to lead the exercise. Some while after the 'pause', the Daily Mirror reported Prime Minister David Cameron's former adviser James O'Shaughnessy admitted the listening exercise was "a sham" – angering Professor Field. He tweeted soon after hearing the news: "I am furious - I was appointed to lead an independent group - independence guaranteed at first meeting with PM." The government's 'pause' did little to allay the medical profession's fears.
Despite the publication of two reports by the NHS Future Forum, in which the government readily accepted the suggested amendments, more and more professional bodies chose to distance themselves from the reforms. Things looked bleak for the government during January 2012 when the Academy of Royal Colleges looked close to issuing a statement opposing the bill – something that would have surely signalled the death of the legislation. It took personal telephone calls from Health Secretary Andrew Lansley to each Royal College chair to dissuade them from such collective action. Lansley has not only endured a backlash from the public over his reforms, a report in The Times quoted fellow Tory MPs who said "he should be taken out and shot" over the miscommunication and mishandling of the legislation.
It remains to be seen whether today's events will ensure he keeps his place in Cameron's cabinet. During the bill's final days in the Lords, the government was dealt, what some thought, would be a fatal blow – the ordering of the release of its transitional risk register. But even that failed to stop the reforms. Dodging the order, the government held out claiming until the full explanation of the decision was published, the document would remain hidden.
Somewhat ironically, a draft version – leaked by health writer Roy Lilley – entered the public domain yesterday, and has had little impact. After all the toing and froing and the inevitable politicisation of the bill, CCGs can now get on with the job in hand.
Question: What are your biggest fears for the NHS under the new health reform?
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