Health and Social Care Act 2012

The Health and Social Care Act 2012, as clarified by, states that it involves the following:

  • establishes an independent NHS Board to allocate resources and provide commissioning guidance
  • increases GPs’ powers to commission services on behalf of their patients
  • strengthens the role of the Care Quality Commission
  • develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS
  • cuts the number of health bodies to help meet the Government’s commitment to cut NHS administration costs by a third, including abolishing Primary Care Trusts and Strategic Health Authorities.


The reforms have been the most significant reforms to the NHS ever with a purpose to abolish NHS primary care trusts and Strategic Health Authorities. A primary care trust is a service which commission primary, community and secondary care from providers. The Strategic Health Authorities are responsible for enacting the directives and implementing fiscal policy as dictated by the Department of Health at a regional level. The reforms were introduced by the ex-secretary of state for health, Andrew Lansley.

The Act was very controversial due to a lot of the proposals not being mentioned in the Conservative manifesto of 2010, but brought up at a later date. But 2 months later a white paper was published outlining the proposal of Health an Social Care reform. White papers are documents which outline future policy as proposed by Government.

The controversial nature of this change in policy can be highlighted by the high level of scrutiny it received – with over 1000 amendments before it could be passed, receiving royal assent on 27th March 2012. Pressure group activity was high with groups such as the British Medical Association lobbying governmental committees to reach an agreement – that was to set up an NHS Forum before the act had passed. Other groups vehemently opposed the reforms, such as ’38Degrees’, ‘NHS Direct Action’ and ‘Keep our NHS public’. Protests had also been frequent with the group ‘UK Uncut’ leading a protest on Westminster Bridge and ’38 Degrees’ rectifying a plethora of billboards across London.

What are your views on the Health and Social Care Act 2012? I would be particularly interested in hearing from Americans who have recently had the Patient Protection and Affordable Care Act (‘Obamacare’) come into law…

Thanks for reading,

Digestible Politics


2 comments on “Health and Social Care Act 2012

  1. It’s interesting – just when Americans are being forced into having the discussion about whether health care is a national right and obligation of if it is in some ways a luxury, European governments are being forced or pressured to cut back on national health care. Still, I’d rather be in the position of determining how much care a citizen is entitled to regardless of ability to pay rather than being asked to decide if a citizen unable to pay for care is entitled to any at all.

  2. Once again I suggest considering what an ‘ideal’ healthcare system would look like. A corollary question might be the purpose of the healthcare system. A good place to start is of course the WHO’s 2000 annual report: The world health report 2000 – Health systems: improving performance (

    ” A sense of progress toward ideals gives life meaning and makes choice significant…Many of our problems derive from a dissatisfaction with some aspect of our current state. For example we do not like the way our car is working…The effort to get rid of what we do not want is ‘reactive.’ The effort to obtain what we want is ‘proactive.’ The chances of overlooking relevant consequences are minimized when we formulate a problem in terms of approaching one or more ideals. Proactive planning consists of designing a desirable future and finding ways of moving toward it as effectively as possible. An idealized design is not utopian precisely because it is capable of being improved. It is the best its designers can conceptualize now, but its design, unlike that of utopia, is based on a recognition of the fact that no idealized design can remain ideal for long. Thus the product of an idealized design is not an ideal state or systems, but an ‘ideal-seeking’ state or system. The idealized design process unleashes creativity because it relaxes internally imposed constraints. It sanctions imaginative irreverence for things as they are and encourages exploration of areas previously precluded by self-imposed and culturally imposed taboos.”
    Russell Ackoff in “The Art of Problem Solving,” 1978, John Wiley & Sons, Inc. p. 25-7.

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