First and foremost, please be assured that I have the highest admiration for everyone who works in the NHS. The NHS saved my life when I was 24. It was there for me in my hour of need, and I always want to make sure that it will be there for everyone else who needs it, irrespective of the ability to pay. I also have two children who work in the NHS, so we are deeply committed to it as a family.
The Health and Care Act provides for more integrated care between the NHS, local government, social care providers and other partners These reforms will continue to improve the quality and sustainability of NHS services and outcomes for patients.
Service provision by the independent and voluntary sectors has been, and continues to be, an important and valuable feature of our healthcare system, which I fully support. ICBs are NHS bodies guided by the NHS Constitution and with the values of the NHS at heart. Safeguards are already in place to ensure that the interests of the public and the NHS are always put first. The ICB chair has the power to veto members of the board and there are robust requirements on ICBs to manage conflicts of interests.
That said, I do appreciate that there are concerns about private sector involvement in ICBs. It is important that people are assured that the work of ICBs is driven by health outcomes, not by profits. No one who could potentially undermine the NHS due to their involvement in the private healthcare sector should sit on an ICB.
The Government amended the Health and Care Act during its passage through Parliament, putting beyond doubt that Integrated Care Boards cannot be controlled in any way by the private sector. The Government’s amendment makes clear that no one may be appointed to an ICB who would undermine the independence of the NHS, either as a result of their interests in the private healthcare sector, or otherwise.
The extension of the conflict of interest policy to the sub-committees of Integrated Care Boards avoids them being inadvertently left out of the legislation.
Primary care commissioners have long had the choice to commission services from a range of primary care providers. I believe it is crucial that local health commissioners have flexibility to commission partnerships, individuals and private and third sector organisations to deliver GP services to meet the specific healthcare needs of their local populations.
Alternative Provider Medical Service Contracts (APMS) offer greater flexibility than national standard contracts, allowing commissioners to better meet local need and fill any gaps not covered by core general practice. Private and third sector providers play a vital role in the delivery of local services and must adhere to the same quality and safety standards as any other form of GP contractor.
I was not in favour of proposed amendments to end APMS contracts, which I believe would have undermined the important ability of commissioners to meet local need, particularly at a time when efforts are being made to build capacity in primary care and ensure commissioners go further in developing and designing high quality primary care services.