HFMA response / Evidence to Health & Social Care Committee’s inquiry: NHS legislative proposals

The HFMA submitted written evidence to the Health and Social Care Committee’s inquiry into the NHS long term plan: legislative proposals.

Key points:

• In our opinion, the legislation should provide guiding principles and overarching objectives, rather than prescribing how they will be achieved.
• Setting principles and overarching objectives, along with long term financial settlements, would allow for necessary long-term planning to achieve the objectives set out in the NHS long term plan.
• Considering the principles and objectives and allowing the service the flexibility to determine how they will be achieved should mean that the primary legislation will not need to be revisited as the way healthcare is delivered changes over time.
• Legislative changes need to take into account the whole NHS and social care system. They should be subject to consultation and debate within Parliament but also with the NHS, and those involved with it, to guard against any unintended consequences. This is particularly the case where very specific, detailed changes are proposed.
• Any change to the existing legislation needs to address the current tension between organisational objectives and statutory duties, and meeting system wide objectives.
• Consideration needs to be given to the number and layers of organisations within the NHS – more organisations and more complexity will demand greater amounts of time and resource to navigate.
• The proposals for legislative change do not address critical issues relating to primary care, value added tax (VAT) and local authorities.

Some of the issues facing the NHS are not going to be resolved by legislation. However, there is some non-NHS specific legislation, particularly in relation to workforce and taxation, which is having a detrimental impact on the sector.