Talk:Health and Social Care Act 2012

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Nicholson challenge

I've moved the following here in order to discuss it:

The proposed changes meanwhile coincide with NHS Chief Executive Sir David Nicholson's so-called "Nicholson challenge", which is entirely separate from the bill and is already being undertaken. Under this "challenge" the NHS is expected to make 4% "efficiency savings" per year, culminating in a total £20 billion by 2015, supposedly in order to find additional funds for increasing costs associated with an ageing population and new drugs and other technologies. Both Nicholson and the coalition government have been careful to use the term "efficiency savings" when referring to these new directives, rather than the word "cuts". By using different terminology the coalition appears to hope to sidestep critics' allegations that PM Cameron is breaking his promise not to cut the NHS. Regardless, the House of Commons health select committee described the savings target as "without precedent in NHS history", adding that "there is no known example of such a feat being achieved by any other healthcare system in the world."^[1] An editorial by the British Medical Journal described Andrew Lansley's attempt to carry out the largest reform in NHS history alongside this attempt to make unprecedented financial savings as "mad".^[2] The "Nicholson challenge" has already resulted in a sweeping cut of 560 ambulance jobs^[3] as of mid-April 2011, and a further report alleges that this is only the most immediate such cut, as a total 890 ambulance jobs are slated to disappear by 2016, saving an estimated £53 million^[4]. NHS administrators openly admit that these jobs do represent the exact "front-line services" that Nicholson and Lansley had both promised would be protected regardless of their NHS shake-up process.
References

^ House of Commons health select committee, 13 January 2011, Health Committee - Third Report: Commissioning - The White Paper Proposals

^ British Medical Journal, 2011; 342:d408, Dr Lansley’s Monster doi:10.1136/bmj.d408

^ http://www.guardian.co.uk/society/2011/apr/12/nhs-chief-intervenes-ambulance-job-cuts

^ http://www.guardian.co.uk/society/2011/apr/12/london-ambulance-service-cut-jobs

If it really is "entirely separate from the bill", why is it brought up in this article in the first place, especially in the lead? If it is to remain in the article it would be more appropriate to have it in a separate section, and focus more on the connection between the "Nicholson challenge" and the bill itself. Gabbe (talk) 10:37, 11 May 2011 (UTC)[reply]

Is the responsibility for health really removed from the Secretary of State as mentioned

This page says in the introduction that the 2012 Act "removed responsibility for the health of citizens from the Secretary of State for Health", and in the White Paper section it says 'It replaces a “duty to provide” with a “Duty to promote”' however this is factually inaccurate.

The NHS Act 2006 can be found here.

The Health and Social Care Act 2012 can be found here.

I am not a lawyer, but if the 2012 Act really "removed responsibility for the health of citizens from the Secretary of State for Health", I can't see where this is stated. The 2012 Act has broadly the same requirements for general health as stated in Section 1 of both Acts, and any distinction is real then it is very subtle. Certainly it does not seem to justify the emotive statement quoted.

Both the 2012 Act and the previous 2006 Act say that the Secretary of State has a "duty to promote" - neither says that the SoS has a "duty to provide", so the statement in this page is factually incorrect. Indeed it can be argued that the 2012 Act actually strengthens the Secretary of State's duty - the 2006 act says "Secretary of State’s duty to promote health service" and the 2012 Act says "Secretary of State’s duty to promote comprehensive health service" adding the word "comprehensive".

The contention that the duty to provide has been lost is based on a legal opinion from a single barrister commissioned by 38 Degrees. 38 Degrees is a campaigning organisation widely viewed as having an agenda (Declaration: I personally support many of the 38 Degree campaigns, but I still believe it has an agenda), and although we should not believe that the barrister concerned was biased, opinions are usually written with a view to showing that a certain legal viewpoint might be proved at a future time in court. So the terms of his brief are likely to have been for him to demonstrate the legal possibility that the "duty to provide" has been lost. It is equally possible that an opinion with an opposite objective could equally or more easily be written. In other words a legal "opinion" is just an opinion, not fact. I therefore believe that all statements regarding the Secretary of State's duty to provide / promote should be deleted.

Edit 1: The government provided a Role of the secretary of state fact sheet which provides an alternative interpretation.

Edit 2: The government produced a response to the 38 degrees legal opinion - if the 38 Degrees opinion is used as the basis for a wiki statement, it needs to be balanced with this.

--Paf uk (talk) 08:34, 9 November 2016 (UTC)[reply]

External links modified

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[HoC13012011-1] House of Commons health select committee, 13 January 2011, Health Committee - Third Report: Commissioning - The White Paper Proposals

[BMJ-2] British Medical Journal, 2011; 342:d408, Dr Lansley’s Monster doi:10.1136/bmj.d408

[3] ttp://www.guardian.co.uk/society/2011/apr/12/nhs-chief-intervenes-ambulance-job-cuts

[4] ttp://www.guardian.co.uk/society/2011/apr/12/london-ambulance-service-cut-jobs

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