Biggest NHS shake-up in more than a decade

Ministers to seize control of the NHS in huge shake-up including powers to put fluoride in water, enforce junk food health warnings and tackle obesity

  •  Ministers are concerned about rising levels of disease linked to poor diet
  • Health chiefs will encourage people to become more active to prevent diseases 
  •  Will be complemented with separate measures to restrict junk food advertising

The NHS will be ordered to focus on changing patients’ lifestyles as well as treating illnesses under new Government plans – which will see ministers seize control of healthcare.

Ministers are concerned about rising levels of disease linked to poor diet and lack of exercise, such as Type 2 diabetes and obesity, a leaked document shows.

It acknowledges smoking rates have fallen in recent years but warns the UK’s growing and ageing population is suffering from more long-term conditions.

Health chiefs will be tasked with not only treating diseases such as cancer, but also helping to prevent them by encouraging people to become more active.

The draft policy paper, leaked to Health Policy Insight, also reveals Boris Johnson has plans to reverse controversial reforms of NHS England which were brought about under the 2012 Health and Social Care Act. 

Under the leaked plans, the Health Secretary would take more direct control.  

The plans were today welcomed by former Health Secretary Jeremy Hunt, who said he believes the reforms could be ‘very positive.’

The NHS will be ordered to focus on changing patients' lifestyles as well as treating illnesses under new Government plans

The NHS will be ordered to focus on changing patients' lifestyles as well as treating illnesses under new Government plans

The NHS will be ordered to focus on changing patients’ lifestyles as well as treating illnesses under new Government plans

He told BBC Breakfast: ‘Last year was the first year in history where, across the world, there were more over-65s than under-fives, so we are all having to deal with this big change in our health provision of the growth in older people and what that means is you need a lot more joined up care.”

‘The structures need to be improved to make that possible and I think that’s what these reforms are intended to do, so I think they could be very positive.’

He later added on the BBC Radio 4 Today programme that the reforms needed to include ‘a proper accountability mechanism’ similar to that of Ofsted as a schools inspector.    

‘How we make sure that the NHS continues to be held accountable for these huge sums of public money is something that, I am sure, people will want to ask,’ he said.

Jonathan Ashworth, the shadow health secretary, told City AM: ‘Ministers need to explain why reorganisation is the pressing priority when 190,000 people are waiting more than 12 months for treatment, and cancer survival rates need to be radically improved.’ 

The plans will be complemented with separate measures to restrict junk food advertising and putting calorie labels on alcohol.

It could also give Government the power to put flouride in water to help prevent tooth decay, something only councils were able to do in the past.

Ministers are becoming increasingly frustrated with local leaders resistant to adding flouride due to budgetary constraints, The Times reports.

The white paper – which would also see forced NHS privatisation scrapped – says the health and care system must continue to ‘adapt and evolve’ to meet the challenges of modern life, including Covid-19.

It reveals local NHS services will be ordered to work more closely with councils to better join up health and social care, as they have during the pandemic.

The document says: ‘One in three patients admitted to hospital as an emergency has five or more health conditions, up from one in ten a decade ago.

It will return some powers from Sir Simon Stevens, chief executive of NHS England, to Matt Hancock, the Health Secretary

‘While smoking rates may be decreasing, diabetes, obesity, dementia and mental health issues are on the rise.’

It calls for care that ‘focuses not just on treating particular conditions, but also on lifestyles, on healthy behaviours and prevention’.

New legislation will scrap red tape surrounding repeated tendering for contracts, so more time and money can be redirected to frontline services.

It will return some powers from Sir Simon Stevens, chief executive of NHS England, to Matt Hancock, the Health Secretary.

The document says: ‘A merged NHS England and NHS Improvement will be placed on a statutory footing and will be designated as NHS England.

‘This will be accompanied by enhanced powers of direction for the Government over the newly merged body.’

Health chiefs will be tasked with not only treating diseases such as cancer, but also helping to prevent them by encouraging people to become more active. Pictured: NHS Chief Executive Simon Stevens

Health chiefs will be tasked with not only treating diseases such as cancer, but also helping to prevent them by encouraging people to become more active. Pictured: NHS Chief Executive Simon Stevens

Health chiefs will be tasked with not only treating diseases such as cancer, but also helping to prevent them by encouraging people to become more active. Pictured: NHS Chief Executive Simon Stevens

The paper, leaked to Health Policy Insight, says the Covid pandemic has demonstrated why better links between health and care are ‘essential’.

It adds: ‘Our proposals will make permanent some of the innovations where Covid-19 has forced the system to improvise new and better ways of working.

‘Bureaucracy has a role to play but it should not stifle innovation. We will put pragmatism at the heart of the system.’ 

The Department of Health and Social Care said: ‘We do not comment on leaks. We are rightly considering where changes need to be made to help us build back better. Full details will be set out in due course.’

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