There has been a lot of discussion and commentary on the health and healthcare bill, which has its second reading in the House of Commons earlier this month. Indeed, the legislation represents some of the most significant changes to the NHS since the Lansley reforms in 2012.

Much of the bill focuses on structural reform and integrated care, with NHS England and NHS Improvement formally merging, while establishing Integrated Care Systems (ICS) on a legal basis, giving them greater permanence.

While there is certainly a debate to be had over the timing of this legislation and the importance of supporting the NHS during the next phase of the pandemic, there are aspects of this bill that the MDU welcomes and supports – Most notable being the formal creation of the Health Service Safety Investigations Body (HSSIB) as an independent and independent body, renamed the Health Service Safety Investigations Body (HSSIB).

We have long defended this movement. Giving the HSIB statutory status will give it a much greater sense of permanence, enshrine its independence and raise the status of its investigations.


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We want the HSSIB to be seen as the organization best positioned to develop investigative methodologies designed to improve learning from patient safety incidents. With this in mind, it is particularly welcome to see clause 94 of the bill making it clear that the purpose of an investigation is to identify risks to patients and to mitigate those risks through improvements in systems and practices. .

Section 94 also clarifies that an HSSIB investigation is not there to assess or determine blame or responsibility, and Section 97 explicitly prohibits the naming of persons providing information to HSSIB (unless they do not ‘consent).

The task of fostering an open learning culture in the NHS is a constant journey, not a fixed destination. The MDU is committed to playing its part in the development of this culture, and we will support legislative measures that we believe will help to achieve this.

GMC and GDC reforms

The Health and Care Bill also includes provisions for the regulation of health professions. A particularly striking feature is found in section 123, where the Secretary of State for Health and Social Affairs would have the power to abolish, merge or delegate regulatory bodies.

The government has already said it is willing to reduce the number of regulatory bodies for health and care professionals from the existing nine. The position of the MDU is clear: the GMC must remain the dedicated regulator of health professionals, and the GDC the dedicated regulator of dental professionals. We will argue this case forcefully when the bill is passed.

The essence of the government’s ambitions to reform the GMC and the GDC can be found in its recent consultation, Reform professional health regulations, protect the public. The MDU submitted a overall response to this consultation.

In short, doctors and dental professionals have waited a long time to see their regulators reformed. Reforms must provide a fair, proportionate and timely regulatory regime. We now want the government to proceed without delay. Given the complexity of the health and healthcare bill, we believe the government is correct in committing to consult on separate secondary legislation to reform the GMC later this year, with a view to its entered into force at the beginning of 2022. We urge the government to respect this timetable and also to ensure that the GDC is not far behind.

The MDU is committed to defending the medico-legal and dento-legal interests of its members, so we will be following the evolution of the health and care bill very closely.

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