Accountable Care Organisations (ACOs) and Accountable Care Systems (ACSs) are being established by NHS England as a new phase in the development of Sustainability and Transformation Plans (STPs). NHS England aim to bring together local NHS organisations, in partnership with social care services, to join up the health and social care system. The Bedford, Luton and Milton Keynes STP is one of the ‘first wave’ of ACOs, and as such this is of particular interest to many of my constituents.
In September, the Department of Health launched a consultation seeking views on changes to regulations required to develop ACO contracts. The Government proposes to make these changes to the NHS without a vote in Parliament, and they will have legal effect from February 2018. These regulations will have far reaching implications for commissioning in the NHS and I agree with you that large scale organisational changes should be subject to proper scrutiny.
As it stands, there are unanswered questions about how ACOs will be accountable to the public, what the levels of private sector involvement will be, and what the implications will be for NHS staff. STPs have been controversial and concerns have been raised that they are a way for the Government to cut NHS services. The Government has not said how it will deliver the funding which would be needed to make ACOs work. Indeed, following the Budget, NHS England said that the Government’s financial settlement will mean the NHS will “not be able to do everything being expected of it” and that difficult decisions will need to be made about which services and treatments it can deliver.
I believe the sustained underfunding of the NHS is stretching the finances of our healthcare services beyond their limits, and there are reasonable concerns that ACOs could be used as a vehicle for greater rationing of treatment locally. In this context, I believe it is essential that the decision on whether to introduce ACOs into the NHS is taken in public, with a full debate and vote in Parliament. This is why the Opposition front bench has tabled an Early Day Motion (EDM 660), as part of a campaign to force the Government to hold a debate on these changes.
I have signed EDM 660 and I agree that the Government should provide Parliamentary time for MPs to debate and vote on whether to introduce ACOs into the NHS. The secrecy in which ACOs have been conceived and are being pushed forward is, I believe, unhelpful and contrary to the Government’s duty to be open, transparent and accountable in NHS decision-making.