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Labour requests debate over ‘controversial’ ACO plans

Labour requests debate over ‘controversial’ ACO plans
7 December 2017



The Labour party has requested a debate in the House of Commons over 'controversial' new Tory plans that will see the implementation of Accountable Care Organisations (ACOs) in the NHS.

The Department of Health (DH) proposed to lay the regulations before Parliament in the New Year, with the regulations coming into effect from February 2018.

The Labour party has requested a debate in the House of Commons over 'controversial' new Tory plans that will see the implementation of Accountable Care Organisations (ACOs) in the NHS.

The Department of Health (DH) proposed to lay the regulations before Parliament in the New Year, with the regulations coming into effect from February 2018.

The DH said: ‘Given the nature and scope of our role in supporting the ACO contract, our consultation on the proposed changes are both appropriate and lawful.'

What is an ACO?

ACOs are rather like an advanced STP, but are contractually integrated into the NHS.

An ACO model supposedly simplifies governance and decision making by bringing together funding streams and allowing one provider organisation to decide how to allocate resources and design care for its local population.

Greater transparency

Labour leader Jeremy Corbyn and shadow health secretary Jonathan Ashworth, as well as other front bench colleagues, launched an Early Day Motion, ‘calling for greater transparency’ on the new plans.

In a letter written to leader of the House of Commons Andrea Leadsom, Mr Ashworth requested that the Government ‘provide Parliamentary time for MPs to debate and vote on the proposed changes’.

The letter reads:‘ACOs are potentially the biggest change which will be made to our NHS for a decade.

‘Yet the Government has been reluctant to put details of the new arrangements into the public domain.

‘There is a lack of clarity about Government’s intentions for ACOs, and in the absence of a strong lead from the Secretary of State, there is again growing public mistrust.’

Health secretary Jeremy Hunt said that he wanted to move towards a ‘more transparent, accountable and open culture’ in the NHS.

But with ACOs, some worry that there will be a lack of accountability to the public, as commissioners hold a contract with a single organisation for the majority of health and care services. 

Private companies

ACOs come from the US Affordable Care Act, with the ‘aim of improving quality while reducing growth in healthcare costs’.

An ACO model supposedly simplifies governance and decision making by bringing together funding streams and allowing one provider organisation to decide how to allocate resources and design care for its local population.

Mr Ashworth said: ‘These ACOs are a step on from the controversial STP process in the NHS, which was the subject of a series of debates in the House of Commons at the end of 2016.

‘The STP proposals included threats of hospitals being closed, staff numbers slashed, A&E services moved miles up the road, and children’s wards being shut.' 

The Health and Social Care Act of 2012 widened NHS commissioning to the private sector. In 2016-17, the NHS spent around £12bn of its total budget on care from non-NHS bodies.

In November 2017, Virgin Care threatened to sue six commissioning clinical groups (CCGs) from Surrey, over the loss of a £82m contract to an in-house NHS provider.

NHS Surrey Downs, one of the six CCGs involved, stated that its liability for the case was £328,000.

Mr Ashworth said: ‘It’s scandalous that NHS money is being wasted on fighting off legal bids from private companies, and the public will rightly want a clear debate about what the Government plans to do about it.'

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