A multitude of questions: Adeline Recruits boss critiques the Health and Care Bill

Olusola Jeboda is the director of Adeline Recruits. Situated in Farnham, Surrey, her company offers dedicated recruitment services to NHS hospitals and residential nursing homes. Writing for The Leaders Council in a special report, Jeboda shares her view on the government’s Health and Care Bill currently going through Parliament, explaining why she believes it raises as many questions as it does answers when it comes to resolving the fundamental issues facing the health and social care sector.

The emergence of the Health and Care Bill raises a multitude of questions. Integrated health and social care services do have the power to make a difference, but we need clarity on where the power will lie in such a system. For instance, ministers do not have any experience of working in the industry, yet this Bill may give them the leverage to interfere in the day-to-day running of the NHS. The NHS Constitution is already treated with little respect and patients and staff do not have a voice. Many clinical decisions that have recently been taken warrant questioning. I doubt, therefore, that further threats to the operational independence of the health service are likely to benefit anyone but government.

In my opinion, any legislative changes must culminate in improved patient outcomes. If there is to be little or no improvement in this area, then the purpose of the Bill must be questioned. We need to properly understand who the beneficiaries of these reforms are.

In addition to this, we must be cautious about giving the private sector greater involvement in the planning and delivery of clinical services. Changes to procurement rules could lead to more private providers coming on to integrated care boards. This gives rise to potential conflicts of interest in the awarding of contracts.

We must also be sure that contracts are not being awarded to new providers without sufficient scrutiny. There are multiple examples of private sector organisations not providing quality care. Robust regulatory systems must be put in place to maintain high standards. New protocols and cost-cutting measures outlined in legislation must not be allowed to compromise the quality of care provided.

We also need to understand whether this Bill will eventually address the very real issues that are currently hampering the industry. At this moment, there is a noticeable lack of ambition in the legislation to tackle workforce issues and this is one of the industry’s biggest problems. We are seeing labour shortages and high rates of absenteeism and staff turnover, all of which have been exacerbated during the pandemic. We need to see strong workforce measures and a fully costed workforce strategy to address these issues.

If the Bill were to be amended to include such a strategy, we could directly tackle labour shortages and boost retention by improving working cultures and taking a more compassionate and inclusive approach to sector leadership. As part of this, we should see members of the public at all levels, from the grassroots up, involved in consultations and decision making.

This written opinion piece is taken from The Leader’s Council’s March 2022 Special Report exploring the effects of the Health and Care Bill. The full report, including Olusola Jeboda’s contributing piece in full, can be found here.