A report by the House of Lords' constitution committee said the current Health Bill could dilute the government's responsibilities regarding the NHS. Therefore it may be necessary to clarify ‘beyond legal doubt’ the government’s responsibility for the NHS, the committee said.
The constitution committee assesses the impact of a public bill and, where appropriate, publishes a report on the bill to inform the Lords.
In its report on the Health Bill, the committee warned that changes to sections concerning the government’s responsibility for the NHS have made it unclear ‘whether the existing structures of political and legal accountability with regard to the NHS will continue to operate’ if the Bill is passed.
The committee warned the Lords that under the Health Bill some statutory duties currently imposed on the health secretary would be placed onto CCGs.
These duties include meeting requirements for hospital accommodation, dental and ambulance services.
Although the health secretary will have a duty to review the ‘effectiveness’ of NHS bodies, this does not cover CCGs, the committee said.
Despite reassurances from the government that the rewording of the Bill does not undermine the health secretary’s responsibility for the NHS, the committee advised under the current wording of the Bill this may not the case.
The report said under the amended section 1(2) of the Bill ‘it is the NHS Commissioning Board and the CCGs that will be responsible for commissioning and providing services, not the secretary of state’.
The committee argued that the ‘it is not self-evident’ whether the proposed changes are a necessary part of the government's reforms.
‘Given the uncertainty as to the interpretation of the provisions proposed in the Bill, could not the relevant wording contained in the 2006 Act be retained?’ the committee said.