Amid the pandemic, Matt Hancock needs to display the humility that his tin-eared predecessor Andrew Lansley lacked
Few would dispute that the Lansley reforms of the National Health Service in England, embodied in the Health and Social Care Act 2012, failed. More than 500 pages long, and often opaquely expressed, the legislation stripped control of the NHS from national and local government, and thus from the public, creating a large new bureaucracy to manage healthcare, drive competition and build a regulated internal market. Coming amid fierce spending austerity, the reforms were often seen as the enabler of a programme of cuts and privatisation. “I could and should have stepped in earlier,” David Cameron admitted in his memoir.
Disastrous though the reforms have been, and clear though the case is for replacing them, a new attempt at reorganisation would be destabilising, mid-pandemic, without strong support within the NHS that it can be implemented sympathetically. Matt Hancock embarked on such an attempt on Thursday, in his Integration and Innovation white paper. His proposals unquestionably cut with the grain of much that NHS England has been advocating to improve integrated care in the past two years. But Mr Hancock will have to make a strong case over the coming weeks if the public is to be persuaded that this reorganisation is the right priority in health policy.
