In its 2019 general election manifesto, the Conservative Party pledged to “strengthen the NHS and social care”. The first session of the current parliament saw government-sponsored primary legislation such as the NHS Funding Act 2020 and Medicines and Medical Devices Act 2021 receive royal assent. Parliament then approved further health and social care-related legislation over the course of the following session, including the Health and Social Care Levy Act 2021. This provided for a new tax, the revenue from which is ringfenced to fund health and social care. It also passed the Health and Care Act 2022 in April 2022. This gave effect to reform plans set out in the 2019 NHS Long Term Plan and the Government’s subsequent integration and innovation white paper, published in 2021.

The Government also published its plan for health and social care reform in the 2021–22 session. Entitled Build Back Better: Our Plan for Health and Social Care, it was published in September 2021.

The Government later published a separate adult social care reform white paper in December 2021 and a health and social care integration white paper in February 2022. That month it also published its response to the House of Lords Economic Affairs Committee report on social care funding and an independent report into adult social care reform following the Covid-19 pandemic that had been undertaken by Baroness Cavendish of Little Venice (Crossbench) in 2020.

In February 2022, NHS England separately published a delivery plan for tackling the Covid-19 elective care backlogs.

1. Government priorities in the new session

On 31 March 2022, the Government said that it would focus on delivering on its strategic health and care ambitions as the country learned to live with Covid. This would include implementing the reforms provided for in the Health and Care Act 2022. It would also include pursuing policy goals falling within the following four priority areas: prevention, personalisation, performance and people.

The Government laid its 2022/23 mandate for NHS England before Parliament on the same date. In a foreword, Secretary of State for Health and Social Care Sajid Javid summarised the broad aims of the ‘four Ps’ as follows:

  • Prevention: doing more to prevent need from arising in the first place.
  • Personalisation: putting people in control of their own care and better empowering patients.
  • Performance: driving up the quality of care by “working smarter”.
  • People: supporting the workforce to deliver.

Mr Javid added that prevention was a central principle that would help to deliver both a sustainable NHS and the Government’s plan to reduce health disparities as outlined in its levelling up white paper. The priority areas had also been the subject of a speech on the Government’s health-related reform ambitions that Mr Javid had given at the Royal College of Physicians in London earlier in March 2022.

Mr Javid also delivered a speech at the Care England conference in March 2022, in which he spoke of the Government’s ambitions for adult social care reform and funding support for the sector. Mr Javid added that a digital health and care plan aimed at improving records access would soon be published.

2. Legislative measures

2.1 Reform of mental health legislation

In January 2021, the Department of Health and Social Care published a white paper on reforming the Mental Health Act 1983. The document set out the Government’s proposals to reform mental health legislation following an independent review on the act published in late 2018. The white paper represented the Government’s response to the independent review report, as well as setting out how the Government intended to reform mental health policy and practice to improve patient experience.

A press release accompanying the white paper said the proposed changes would “deliver parity between mental and physical health services and put patients’ views at the centre of their care”. The measures would also seek to:

[…] tackle mental health inequalities including disproportionate detention of people from black, Asian and minority ethnic (BAME) communities, the use of the act to detain people with learning disabilities and autism and improve care for patients within the criminal justice system.

The Government sought views on the implementation and impact of the proposed reforms during a consultation that ran until 21 April 2021. At the time of the May 2021 Queen’s Speech, the Government added that its consultation response would “pave the way for future legislation”.

The Government responded to the consultation in July 2021. It said that it “committed to legislate so that patients suffering from mental health conditions […] have greater control over their treatment and receive the dignity and respect they deserve”. The Government added that it would bring forward a draft Mental Health Bill “when parliamentary time allows”. In February 2022, in a letter to House of Commons Health and Social Care Committee chair Jeremy Hunt, Sajid Javid reiterated that this remained the Government’s intention.

In April 2022, the Department of Health and Social Care published a 12-week call for evidence for a new 10-year plan to improve mental health. The consultation will run until 7 July 2022.

2.2 Banning conversion therapy

In the May 2021 Queen’s Speech, the Government said that it would pursue a ban on conversion therapy. Characterising the practice as “abhorrent”, the Government added it was “determined” for the UK to continue as a “global leader in lesbian, gay, bisexual and transgender (LGBT) equality”.

A group of bodies, including NHS England and several professional medical associations, has described conversion therapy as:

[…] an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of sexual orientation or gender identity, or seeks to suppress an individual’s expression of sexual orientation or gender identity on that basis.

The Government launched a consultation on banning the practice in October 2021. It said that responses would inform draft legislation to be prepared by spring 2022. This would then be introduced “as soon as parliamentary time allows”. The Government published three research reports on the subject alongside the consultation launch. It later extended the consultation to “ensure the widest possible views are taken into account”.

On 31 March 2022, it was reported that ministers would explore non-legislative routes to stop the practice. However, the Government was later reported to have said it would now pursue a legislative ban as originally planned, following what was described as a “furious backlash” to the earlier reports, although such a ban would no longer cover the issue of gender identity. On 21 April 2022, the Government repeated that it was “committed to bringing forward legislation, when parliamentary time allows, to ban conversion therapy”.

Background information on the practice, including a summary of challenges for policymakers to consider, can be found in the following Parliamentary Office of Science and Technology (POST) briefing: Conversion Therapy (16 December 2021).

2.3 Unpaid carer’s leave

In its response to a consultation on carer’s leave published in September 2021, the Government said it would “introduce a new leave entitlement for unpaid carers through legislation when parliamentary time allows”. It said this would become a “day one statutory employment right”, to be brought in “alongside other measures which will also support unpaid carers”.

On 3 May 2022, the Times reported that the Queen’s Speech was no longer expected to include an employment bill that would have included provision for unpaid carer’s leave. The article said the Government was instead considering whether it could support a private member’s bill on the issue.

Cover image by ar130405 on Pixabay.