Memorandum to the Public Bill Committee for the Health and Social Care Bill

This briefing sets out our analysis of the redrafted legislation for the Health and Social Care Bill.


Published: 27/06/2011

Download the briefing [PDF 237.4KB]

Following the end of the NHS Listening Exercise, the amended Health and Social Care Bill has returned to the Commons. Read our briefing which sets out our analysis of the redrafted legislation.

The Health and Social Care Bill was published in January 2011 but its progress was delayed when the Government initiated a ‘Listening Exercise’ on 6 April 2011 in response to concerns about the proposed reforms. This was led by the NHS Future Forum, chaired by Professor Steve Field, and professionals, patients, members of the public and policy experts were consulted. The NHS Future Forum published its recommendations on 13 June and the Government response to the NHS Future Forum report was published on 20 June.

Following the completion of the NHS ‘Listening Exercise’, the amended Health and Social Care Bill has now returned to the House of Commons where it will undergo detailed scrutiny by a panel of MPs before being put to a further vote. This briefing contains our preliminary analysis of the redrafted legislation. You can also watch a recording of Nuffield Trust Chief Executive Dr Jennifer Dixon’s appearance before the panel.

The essential question posed by Nuffield Trust researchers as they examine the revised clauses placed in Part 1 of the Bill (commissioning reform) and Part 3 (economic regulation) has been: is it going to be possible to extract the efficiencies that the NHS needs while laying the foundations for a more sustainable NHS in the medium term, and if so, would the revised Bill make this task easier?

Ultimately it is fundamental reform on the provider side that will unlock the efficiencies required to put the NHS on a more sustainable footing

The briefing makes a number of important observations, including:

  • The Government’s plans increase the number and complexity of ‘soft’ accountability arrangements locally. This may have an effect on the clinical commissioning groups that need to act quickly in order to redesign services that meet local needs
  • The addition of a significant layer of consultation and governance requirements for clinical commissioning groups call into question the original assumptions for administrative spending detailed in the January 2011 impact assessment
  • There continues to be a lack of detail about the Government’s intentions in respect of financial incentives for commissioners to improve quality.

This paper builds on the latest of the Nuffield Trust’s policy response briefings: The Health and Social Care Bill: where next? This report analysed the main areas of controversy surrounding the Bill and suggested several measures for their resolution.

Our experts continue to examine the reforms in detail – visit our dedicated project page for all our related resources on the Health and Social Care Bill, including publications and blogs, video interviews, slideshows and press releases.

Suggested citation

Nuffield Trust (2011) Memorandum to the Public Bill Committee for the Health and Social Care Bill. Briefing. Nuffield Trust.