The Health and Social Care Act 2012 (c 7)

The Health and Social Care Act 2012 (c 7) is an Act of the Parliament of the United Kingdom. It is the most extensive reorganisation of the structure of the National Health Service in England to date.[1] It proposes to abolish NHS primary care trusts (PCTs) and Strategic Health Authorities (SHAs). Thereafter, £60 to £80 billion of “commissioning”, or health care funds, will be transferred from the abolished PCTs to several hundred “clinical commissioning groups”, partly run by the general practitioners (GPs) in England. A new executive agency of the Department of Health, Public Health England, is planned to be established on 1 April 2013.[2]

The proposals are primarily the result of policies of the Secretary of State for Health, Andrew Lansley. Writing in the BMJ, Clive Peedell (co-chairman of the NHS Consultants Association and a consultant clinical oncologist) compared the policies with academic analyses of privatisation and found “evidence that privatisation is an inevitable consequence of many of the policies contained in the Health and Social Care Bill.”[3] Lansley says that claims that the government is attempting to privatise the NHS are “ludicrous scaremongering”.[4]

The proposals contained in the Act are some of the coalition government’s most controversial. Although many measures were included in the Conservative Manifesto,[5] they were not discussed during the 2010 general election campaign and were not contained in the 11 May 2010 Conservative – Liberal Democrat coalition agreement,[1] which mentioned the NHS only to commit to a real-term funding increase every year.[6] 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”.[7] The bill was introduced in the House of Commons on 19 January 2011.[8][9] 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. The Bill received Royal Assent on 27 March 2012. The Act’s proposals were not discussed during the 2010 general election campaign and were not contained in the 20 May 2010 Conservative – Liberal Democrat coalition agreement,[1] which declared an intention to “stop the top-down reorganisations of the NHS that have got in the way of patient care”.[7] However, within two months a white paper outlined what the Daily Telegraph called the “biggest revolution in the NHS since its foundation”.[7] The white paper, Equity and Excellence: Liberating the NHS,[10] was followed in December 2010 by an implementation plan in the form of Liberating the NHS: legislative framework and next steps.[11] The bill was introduced into the House of Commons on 19 January 2011[8] and received its second reading, a vote to approve the general principles of the Bill, by 321-235, a majority of 86, on 31 January 2011.[12]