The announcements of plans for accountable care organisations (now known as integrated care organisations) has led to considerable discussion and argument amongst commentators on the NHS and healthcare in England. These commentators include MPs, leaders in various sectors of the NHS, such as GPs and managers, think-tanks, and organisations that campaign to save the NHS from privatisation. We've put together a few of their comments here.
Sarah Wollaston, chair of Commons Health Committee, has written to the Health and Social Care Secretary urging him to delay a new contract for ACOs - due to be implemented later this year. She claims there is a "great deal of concern" over the plans which she considers "have not been well aired publicly up until now".
BMA chair Dr Chaand Nagpaul wrote in his new year message that the union would continue to oppose competition and procurement legislation, which - alongside the development of ACOs - could open the door to NHS services across 'entire localities being run by commerical organisations'.
The Department of Health says - "The NHS will remain a taxpayer-funded system free at the point of use; ACOs are simply about making care more joined-up between different health and care organisations"
[...] "Our consultation on changes to support ACOs is entirely appropriate and lawful. We believe it is right that local NHS leaders and clinicians have the autonomy to improve care for the patients they know best - and any significant local changes are always subject to public consultation and due legal process."
UNISON - "Some STP plans include proposals to privatise clinical support services and "back office" admin; and to establish Accountable Care Organisations, the model preferred by US private healthcare, to manage all care in a locality, ACOs could themselves be privatised."
NHS Providers - "The prize for getting it right will be improving patient care, integrating pathways and getting better value from collective coffers. But this is unchartered territory and with parliamentary time tied up with Brexit, aspirations for new models of accountable care must be delivered within the existing legal frameworks."
Chris Ham, chief executive, The King's Fund - "Integration within the NHS and between the NHS and local government is already happening in many areas and is bringing benefits to patients. NHS England's decision to delay the use of the controversial ACO contract provides an opportunity for them to explain what the contract adds to the existing ways of integrating care, and indeed whether it is needed at all at this stage. In the meantine, NHS leaders at a local level are finding ways of using existing flexibilities to make progress. Ultimately, amendments to the 2012 act will be needed to align current developments with the law, as the Conservative party's 2017 manifesto recognised.
Keep Our NHS Public - "ACOs will help strip NHS assets, such as land and buildings, so ending the soical ownership of much of the NHS estate while allowing private companies to profiteer from it."