More health service reform on the way

The government has published a new white paper setting out planned reforms to health and social care services. Integration and innovation: working together to improve health and social care for all sets out proposals for health and social care to work more closely together as well as tackling major public health challenges like obesity, with a focus on the ‘the health of the population, not just the health of patients’.

The government aims to ‘remove much of the transactional bureaucracy that has made sensible decision-making harder’, it states, and ensure a system that is ‘more accountable and responsive’. Shadow health secretary Jonathan Ashworth, however, questioned the wisdom of reorganisation ‘in the midst of the biggest crisis the NHS has ever faced’. Many of the document’s proposals to address fragmentation in the NHS would undo previous reforms carried out under health secretary Andrew Lansley in 2012. 

The document also contains a proposal to amend the Food Safety Act 1990 to allow strengthened labelling requirements that ‘best meet the needs of the consumer to make more informed, healthier choices’. This would include mandatory alcohol calorie labelling, it states, something alcohol health organisations have long been calling for.  

‘Even before the pandemic, it was clear reform was needed – to update the law, to improve how the NHS operates and reduce bureaucracy,’ said health secretary Matt Hancock. ‘Local government and the NHS have told us they want to work together to improve health outcomes for residents. Clinicians have told us they want to do more than just treat conditions – they want to address the factors that determine people’s health and prevent illness in the first place. And all parts of the system told us they want to embrace modern technology: to innovate, to join up, to share data, to serve people and, ultimately, to be trusted to get on and do all of that so they can improve patient care and save lives.’

While obesity was on the rise ‘it must not be forgotten that alcohol harm is also spiralling out of control and has serious consequences for individuals, families and communities across the country’, said chair of the Alcohol Health Alliance Professor Sir Ian Gilmore. ‘We are already paying much too high a price for alcohol harm and this appears to have worsened during the COVID-19 pandemic. The number of at-risk drinkers has almost doubled since the start of the first lockdown, and more than 5,000 alcohol-specific deaths were registered between January and September 2020 – up 16 per cent on the same months in 2019.’

Tackling the fragmentation of the NHS provided an opportunity ‘to join up alcohol treatment services that have sunk to an all-time low, while at the same time targeting prevention’ he added. ‘As a next step, the government must urgently introduce an alcohol strategy to combat alcohol harm and improve access to treatment for those who need it. We can no longer afford to overlook this gaping hole in public health policy.’