A. C. L. Davies

This Time, it's for Real: The Health and Social Care Act 2012

This article examines the Health and Social Care Act 2012 and associated reforms to the National Health Service in England. It focuses on the Acts policy of making the NHS market more ‘real’, by both encouraging and compelling NHS bodies to act as ‘market players’. The article considers whether the reforms are compatible with the constitutional requirements of accountability for the provision of a public service such as the NHS. It argues that the reforms threaten accountability for three reasons: they make the Secretary of State for Healths relationship with the NHS more complex, they create opaque networks of non‐statutory bodies which may influence NHS decision‐making, and (especially in relation to competition) they ‘juridify’ policy choices as matters of law. Taken together, these arguments suggest that there is force in the claim that the reforms will contribute to ‘creeping’ – and thus unaccountable – privatisation of the NHS.This article examines the Health and Social Care Act 2012 and associated reforms to the National Health Service in England. It focuses on the Acts policy of making the NHS market more ‘real’, by both encouraging and compelling NHS bodies to act as ‘market players’. The article considers whether the reforms are compatible with the constitutional requirements of accountability for the provision of a public service such as the NHS. It argues that the reforms threaten accountability for three reasons: they make the Secretary of State for Healths relationship with the NHS more complex, they create opaque networks of non-statutory bodies which may influence NHS decision-making, and (especially in relation to competition) they ‘juridify’ policy choices as matters of law. Taken together, these arguments suggest that there is force in the claim that the reforms will contribute to ‘creeping’ – and thus unaccountable – privatisation of the NHS.

The public law of government contracts

1. Introduction 2. Regulating Government Contracts 3. The Public Law Perspective 4. The Decision to Use Contract 5. Awarding the Contract 6. Dealing with Policy Changes 7. Contract Management 8. Government Contractors: Public or Private? 9. Social and Environmental Goals 10. Employment Matters 11. Conclusions and Future Prospects

A Tangled Web? Accountability and the Commissioning Role in the ‘New’ NHS

The National Health Service (NHS) is in a constant state of flux. A new round of major structural reforms takes place every few years. It is not uncommon for a new organisation to be abolished before it has had time to establish itself. Job interviews are almost routine for staff as one type of organisation is replaced by another, and there is an ongoing threat of redundancy. It seems self-evident that the NHS is unlikely to thrive under these conditions. However, this has not deterred ministers from further changes as they grapple with public pressure to generate noticeable improvements in NHS services and to justify the large sums of taxpayers’ money now spent on health care. The latest round of reforms focuses on the primary care sector.1 The reforms reduce the number of NHS bodies involved in primary care. They seek to increase the involvement of GPs in designing primary care services and in purchasing secondary services from other parts of the NHS. And, to some extent, the government suggests that a market for the provision of primary care services might evolve in the future, with increased provision of primary care services by the private and voluntary sectors as well as by the NHS. It is no surprise to discover that cost-cutting plays a major role in the justification for the reforms. But there is also a clear agenda to redress the balance between primary and secondary care. Previous reforms (notably the introduction of Foundation Trusts2) have focused on secondary care and there is a concern that primary care bodies