The Health and Care Bill tonight passed its third reading in the House of Commons, despite concerns being raised over staff shortages and the presence of private representatives on NHS boards
The Health and Care Bill will replace 100 or so Clinical Commissioning Groups with Integrated Care Systems (ICSs) in 42 regions of England.
It passed its third reading by 294 votes to 244 after the government fended off last-minute amendments by Labour and Mr Hunt.
The general purpose of the Bill has been welcomed by health think tanks, as it unpicks many of the disastrous 2012 reforms pioneered by Tory Andrew Lansley.
But there are a string of issues that have caused controversies across the spectrum of British politics.
Labour tried to block any private healthcare representatives – except GPs – from sitting on new-style health boards that commission care.
And Mr Hunt tried to force the government to publish independent workforce projections twice a year to solve the staffing crisis.
Private healthcare reps will only be blocked if they “could reasonably be regarded as undermining the independence of the health service”.
And ministers will only have to report “at least every five years” on workforce needs, which health experts say is not enough.
Sajid Javid also defeated a bid to strip out controversial new powers for his office.
Currently, controversial changes to NHS services can be referred to government. But under the Bill the Health Secretary can intervene in minor local plans at any time.
The Kings Fund warned it could cause a “logjam” of decisions adding: “It risks bringing political calculations into decisions that should be made on the basis of patient need.”
But a Labour amendment to strike out the power grab failed by 307 votes to 191.
Nurses expressed their “disbelief” after Tory MPs voted down the Jeremy Hunt amendment, which was backed by nearly 60 of the UK’s most prominent health and care organisations.
Currently there are no independent analysis as to how many medics are being trained in the pipeline to meet estimated future demand.
Patricia Marquis, director of the Royal College of Nursing in England, said: “A broad coalition of professional, political and public support has been overlooked by a Government still unwilling to solve the staffing crisis in the NHS and care system.
“There is widespread disappointment and disbelief this evening. When vacancy levels are so high, the move is short-sighted at best and wilfully reckless at worst.”
There are around 100,000 NHS staffing vacancies advertised in England.
The Health Foundation projects an extra 4,000 doctors and 17,000 nurses will be required to clear the backlog.
Nowhere near the amount deeded are thought to be in the training pipeline.
Mr Hunt, now chair of the Health and Social Care Committee, told MPs: “Yes this will cost the NHS money, but it will save the NHS even more money, because every additional nurse or doctor is an additional locum we don’t need to employ.
“Because locums are more expensive and less good for patients, because t makes it harder for them to see the same doctor.”
Meanwhile the move to let new-style Integrated Care Boards (ICBs) include private health representatives, alongside NHS clinicians and council public health leaders, as part of their make-up as prompted a row.
Health minister Edward Argar suggested claims about private sector involvement in the NHS after the Bill were “misleading and inaccurate”.
The minister said “no one will be appointed to an ICB (integrated care board) who would undermine the independence of the NHS”.
He added: “It was never the intention for independent providers to sit on independent care boards and it still isn’t. We were clear that the conflict of interest provisions, despite misleading and inaccurate claims by some campaigners and others, address this.
“However, we are clear, we are happy to put this even further beyond doubt, the amendment makes clear that no one will be appointed to an ICB who would undermine the independence of the NHS.”
But the Unite union branded it an “NHS privatisation Bill”, with general secretary Sharon Graham saying it will be “used to further run down the NHS and to bring in more privatisation by the back door.”
Labour’s Justin Madders added: “This is really about who runs the NHS.
“There is a complete and utter incompatibility between the aims of private companies and what we say should be the aims of the NHS and the ICBs.”
Labour also raised concerns about a new rule that will mean not all NHS services go out to competitive tender. It is designed to cut down the commercialisation of services but critics fear it will be abused to hand out “crony contracts” or re-award to firms regardless of their performance.
The Bill also contained a controversial change to the government’s new cap on social care payments, which will make it £900m a year less generous for poorer homeowners.
It will now undergo scrutiny in the Lords before any amendments return to the Commons, potentially only next year.