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Labour seeks to mollify reorganisation fears

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Labour has sought to reassure clinical commissioning groups that its health reforms would not amount to a top-down ‘big bang’ shake up of the NHS.


In an exclusive article for, the shadow health secretary’s parliamentary private secretary said the party’s plans to introduce “whole person care” would be introduced in an “evolutionary process”.

Debbie Abrahams said proposed changes, which would see the transfer of some commissioning powers from CCGs to health and wellbeing boards, represented “reforms without reorganisation”.

Debbie Abrahams

Labour’s plans are ‘reforms without reorganisation’, says Debbie Abrahams

Under the plans, HWBs will be expected to integrate physical and mental healthcare with social care by drawing up “collective commissioning plans”. These would be implemented by CCGs and local authorities. Ms Abrahams said the party was currently consulting on the “best model on how HWBs can work with CCGs”.

The MP said: “We recognise the concerns some CCGs have about this and understand that some HWBs are more equipped to undertake this role than others. But to repeat a well used phrase: ‘there will be no top-down reorganisation’, this will be an evolutionary process not a big bang.”

Labour would only allow boards to take on commissioning once they had been deemed competent. The party was developing criteria to assess HWB competence, she added.

Ms Abrahams also pointed to a shift in Labour’s attitude towards personal health budgets. She said Labour had “serious concerns” about the use of the budgets because it could pave the way for the introduction of a health insurance payment regime.

Such concerns appear to clash with comments from her shadow health colleague, Liz Kendall, who described personal health budgets as “an important way of ensuring a publicly funded health system can do the things that people really want”.

Ms Abrahams also appeared to hint that Labour could make changes to the quality and outcomes framework used to incentivise GPs.

“If about 30 per cent of a GP’s income is performance related through QOF this may influence their focus and may also have unintended consequences.”

Ms Abraham’s column follows the recent publication of Labour’s National Policy Forum annual report, which says the party’s commitment to whole person care will “progressively reduce the purchaser provider split across the NHS”.

The document forms Labour’s official policy programme ahead of next year’s general election.

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