This House of Lords Library Briefing has been prepared in advance of the debate due to take place in the House of Lords on the motion moved by Lord Darzi of Denham (Labour) “that this House takes note of the creation of the National Health Service in 1948, and the case for integration of health, mental health, social and community care to equip the National Health Service for the next 70 years”. It provides a short history of the National Health Service (NHS), and summarises recent debates surrounding the integration of healthcare in England.
NHS and Integrated Healthcare Services (414 KB , PDF)
A five year plan published by NHS England in 2014 stated that there was a broad consensus in favour of removing the boundaries between different healthcare providers. Indeed, both governmental and non-governmental bodies have put forward the case for integrated care. The current Government reiterated its support in its recent announcement of real terms funding increases for the NHS, and the Labour Party has also stated that it is in favour of an integrated healthcare service. Reasons put forward include that it can lead to a more efficient use of resources and better outcomes for patients.
The five year plan set out how NHS England intended to achieve an integrated approach. This was primarily by creating organisations at the local level which would deliver a range of care services, potentially with delegated budgets. Reviews of progress since, including by the National Audit Office (NAO), have been mixed. The NAO concluded that there was no compelling evidence that integration provided financial savings or reduced hospital activity. However, NHS England has put forward examples of successful integration in some local areas. Meanwhile, developments continue in the various components of an integrated care system in England. For example, the Government has set out an intention to increase funding and staffing of mental healthcare, with a view to treating an extra one million patients a year by 2020/21, and achieving “parity of provision” with physical health services. On social care, a proposed green paper has been delayed, but is expected to be published this autumn. The Government has recently announced a funding increase for the NHS.
NHS and Integrated Healthcare Services (414 KB , PDF)
This briefing looks at the Social Fund Winter Fuel Payment Regulations 2024. These regulations would introduce means testing for the winter fuel payment. They are the subject of a motion by Baroness Altmann (non-affiliated) to annul them. The House of Lords Secondary Legislation Scrutiny Committee has also drawn the regulations to the special attention of the House.
Between 1970 and the early 1990s, over 30,000 NHS patients were given blood transfusions, or treatments made using blood products, which were contaminated with hepatitis C or HIV. Over 3,000 people have since died, and thousands more live with health conditions. The infected blood inquiry called for immediate compensation, public memorials, and for lessons to be learned in medicine, government and the civil service. In August 2024 the government set out plans for compensation.
Vaginal mesh implants are used to repair damaged internal tissue. However, many women receiving these implants have experienced severe complications. In 2020, an independent review recommended establishing a compensation scheme for the women affected. The Conservative government rejected this recommendation, saying its focus would be on improving product safety. However, calls for redress have continued, with a subsequent review in 2024 also recommending the establishment of a compensation scheme.
