“Integrated Care Systems” and the Health and Care Bill 2021

Scroll down this page for:
1:  Bad news for patients and staff – Integrated Care Systems and the Health and Care Bill 2021 
2:  Action:  
⇒ Sign the “We Own It” and “Keep Our NHS Public” petitions 
⇒ Email your MP
⇒ Liaise with political groups and trade unions (model motions) 
⇒ Circulate leaflets / provide information
⇒ Share social media
3: “Integrated and Caring”?  Definitely not.
4: Impact on the pay, terms and conditions of NHS staff
5: Impact on local decision-making and democracy 
6: Opposition to the Health and Care Bill
7: The passage of the Health and Care Bill through Parliament
8: Tyneside street theatre with a serious message
9:  The views of campaign groups
10: National KONP responds to the Government
11: Links – newspaper items, opinion pieces, reports
12: Map of “North East and North Cumbria ICS”
13: Contextual information: The NHS Long Term Plan (2019), the White Paper (2021) and the NHS “Consultation” on ICSs (2021)
14: STPs” and “ACOs” – remember them?



george monbiot

George Monbiot: “People are amazed that the government is going ahead with a massive “reorganisation” of the #NHS, despite the chaos caused by the pandemic. But this is to misunderstand disaster capitalism. It’s going ahead now BECAUSE of the chaos, hitting when the NHS is least able to resist”.   12th July 2021 @GeorgeMonbiot



Bad news for patients….

and staff….

Sunny days, dark news: Spreading the word about the Governments plans to NHS staff, day patients and visitors outside the RVI (21st July) and Freeman (29th July) 
and KONPNE outside North Tyneside General (together with members of Momentum North Tyneside, 9th August) and at the Monument in Newcastle (with members of Morpeth Branch Labour Party, 14th August) 
Joan Hewitt (together with friends) leafletting the Whitley Bay area, and KONPNE getting the word across in Consett (joined by local Labour Party Secretary Andy Plant, 28th August 2021
Great to have the support of local people and organisations…..MUCH appreciated.
Leaflets may be purchased (very cheaply) from the national KONP website here ….and please let us know where you are leafletting: konpnortheast@gmail.com




Sign the “We Own It” and “Keep Our NHS Public” petitions,
Email your MP,
Liaise with political groups and trade unions (incl model motions) and
Circulate leaflets / provide information
Share social media
Please read on for information about each of these actions, get involved with the Campaign, and let us know how you get on….we’re at konpnortheast@gmail.com



Sajid Javid
This Bill will mean MORE American-style privatisation of our health service. The plans will give private companies BIGGER roles in decision-making and MORE contracts without any checks and balances. This government is hellbent on involving the private sector in our health service further.  But they know this isn’t popular. That’s why they’re putting this spin on these reforms. It’s smoke and mirrors.  
THE REALITY: These new plans would 1) Allow private companies like Deloitte to sit on boards that make decisions about how to spend NHS money   2) Introduce the American model into our NHS where unaccountable decision making bodies prioritise profit margins and making savings over caring for people’s health. This model is likely to lead to cuts and closures of NHS hospitals and A&E   3) Push more people to go private as cuts are made. Patients have already been promised greater rights to choose private treatment and have it paid for by the NHS   4) Open the door to more cronyism –  yet more contracts would be given to government pals like Serco, as we’ve seen in the pandemic, but without any competition – that’s what the government means by ‘reducing bureaucracy’   5) Encourage private companies to take the NHS to court if they’re unhappy. 
What we actually need is a national high quality, well funded, public NHS for everyone. 3 out of 4 of us want our NHS reinstated as a fully public service after the pandemic. We want an NHS run for the public, not profit. And we are going to fight for it.
To sign the “We Own It” petition




KONP Protect the NHS


We have to stop the Health and Care bill passing through parliament right now before it damages the NHS we know and love. It will mean the handing out of NHS contracts to private companies with friends in the government. We have seen this happening during the pandemic and it’s been a disaster. For example, £37 billion was wasted on a ‘test and trace’ service that simply didn’t work.
To sign the “Keep Our NHS Public” PROTECT THE NHS petition




It will take around 10 minutes to email your MP, requesting that s/he is proactive in opposing the Health and Care Bill 2021. Please feel free to highlight some of the issues identified on this webpage, and ask for a response to your email.
Here  is a model letter from national KONP, devised to send to MPs. Please do not hesitate to copy and paste, and amend this, as required. It is crucial to keep the pressure on. 
Alternatively, an abbreviated version is here – please feel free to print off, sign and send, or copy and paste onto an email….
The email addresses of all North East MPs are located on our links page here.
This is democracy in action – please ensure that your voice is heard.

letter MPs Health Bill-page0001

Whilst emailing your MP is the absolute priority, if you have time it would be great to go one step further and send copies to local Councillors. The names and email addresses of your ward councillors can be found on your Councils website; if you already know the names of your local councillors, then their email addresses are listed on our links page here. If possible, please also copy in the Chair of the Councils Health and Wellbeing Board, and the Chair of the Councils Health Scrutiny Committee – they can be identified through your Councils website, and their email addresses can be found on our links page. For good measure, please also copy in your local Healthwatch group – on our links page here



It would help greatly if supporters liaise with any political groups or trade unions they may be a member of – it is crucial that they hear your views about these issues. 
“Oppose Integrated Care Systems in the English NHS: Model motion for trade unions” – click here
“Oppose Integrated Care Systems in the English NHS: Model motion for Labour branches and CLPs” – this can easily be adapted for use by other political parties and organisations – click here
NB – these draft motions were written before the Health and Care Bill, so please also make reference to opposing the Bill in your motion.
Much respect to Morpeth and Pegswood Branch Labour Party. The above motion, was debated and was unanimously passed by the Branch at their meeting in mid-March 2021. It was clear that what is needed is legislation to bring about a universal, comprehensive and publicly provided NHS, fit for the 21st century…  It is great that this motion is supported in Morpeth and by many other Branches and CLPs – and, indeed, by other political parties, Unions and organisations throughout England. Not yet passed by your group? Please do everything you can to move this forward. THE PROPOSED ICS LEGISLATION MUST BE STOPPED.
Click here to listen to Margaret Greenwood MP : “I’ve called on the government to pause its plans for a major reorganisation of the NHS. It’s just plain wrong in the middle of a pandemic when staff are exhausted and public meetings can’t take place”   24th February 2021. 
The following excerpt is from the Labour Policy Forum, 3rd February 2021. The Health and Social Care Policy Commission develops Labour policy and thinking on areas including the future of the NHS, mental health, public health and social care.
“Although successive Labour Party conferences since 2016 have voted to actively oppose NHS England’s integrated care systems and Long Term Plan, Labour has not yet implemented this policy. It was therefore very good news that at the Health and Social Care Commission on 27.1.21, Jonathan Ashworth (accompanied by Rosena Allin-Khan) committed labour to actively repeal all legislation enabling or supporting integrated care systems. This should now be urgently translated into action by all members of the shadow front bench, the PLP and Labour councillors, to actively oppose all national and local arrangements and/or policies aimed at facilitating integrated care systems and/or facilitating the Long Term Plan (LTP). It has been clearly established that the LTP originated in papers drafted by McKinseys at the Davos World Economic Forum in 2012. The overall aim was to undermine and eventually privatise public health care systems throughout the world. Successive governments have developed proposals of this sort since the 1980s; NHS England’s forthcoming proposals for legislation on integrated care systems will finally achieve it unless Labour actively opposes this”
Alex Scott-Samuel, 3rd February 2021: click here
Whilst KONPNE members support a range of political organisations and parties (or none),  we are clear that KONPNE as a campaign group is not aligned to any trade union, political party or organisation. Our attention is focused solely on the NHS, and KONPNE members come together to actively campaign for a publicly funded, publicly provided and publicly accountable NHS. We are happy to report on any initiatives that fit with these beliefs.



A key Campaign intervention is getting the word out about what is happening – and there are a range of leaflets provided by national KONP…..please share with all friends and contacts…. information is key to this Campaign….
Please feel free to print out and circulate the leaflets below, or share electronically
the leaflets below may be purchased (very cheaply – 100 leaflets for £3, or 500 leaflets for £9, or other quantities and prices…) from the national KONP website here: https://keepournhspublic.com/product/ics-leaflet-patients/
We are aware of a number of initiatives where this has been taken forward by individuals. Why not order 100 and leaflet your street? Or arrange for your social group or political organisation to leaflet an area
…and please send us some pix and let us know where you are leafletting: we are at konpnortheast@gmail.com THANK YOU ❤
> A5, 2 sided leaflets to distribute to the public: click ICS-leaflet-for-patients
or click on 
> A5, 2 sided leaflets to distribute to NHS staff: click ICS-leaflet-for-staff
or click on
> A slightly older leaflet: A4, 2 sided info sheet: click ICS info sheet A4 2021
or click on
> A slightly older leaflet: A5, 2 sided flyer leaflet: click ICS flyer leaflet A5 2021
or click on 


The new (October 2021) “Health Campaigns Together” briefing is here – please feel free to circulate, print off, or order copies from healthcampaignstogether@gmail.com 








Please watch and share the following Videos on your social media (click the “share” arrows at the top right hand corner)
Our own KONPNE video:

and from We Own It:

and from Public Matters:

from Dr David Wrigley (British Medical Association / GP):
“This bill is being rushed through Parliament giving very little time to discuss and scrutinise the bill – too many areas of the bill lack any clarity of what it would achieve and why it is needed. It doesn’t result in any effective change.”

Dr Sonia Adesara (Hospital Doctor):
“This Bill does nothing to support NHS workers, this Bill does nothing to reduce waiting time, this Bill does nothing to reduce the rising health inequality that we are seeing in this country.”





“Integrated and caring”?   DEFINITELY NOT.


MPs are currently faced with a vote on the Health and Care Bill (2021) which, if passed, would confirm what are known as “Integrated Care Systems” as “NEW NHS BODIES”. These will divide up the NHS into approx. 42 pots of money with limited ‘population health budgets’ designed to find more ‘efficiency savings’ or, as we know it, CUTS. The number of commissioning organisations would be reduced from almost 200 to just 42 ICSs – this requires merging (and eventually abolishing) local “Clinical Commissioning Groups” (established as public bodies by the Health & Social Care Act 2012).
Here, in the North East, we sit within the “North East and North Cumbria Integrated Care System”, which covers a huge geographical area from Cumbria in the west, to Berwick in the north and to Whitby in the South – scroll below to see the map and the organisations involved. This (and a number of other ICSs across England) is already in place as a partnership organisation, but without legal status and statutory powers, and with no public accountability; if the provisions of the Health and Care Bill 2021 are voted in, then this huge organisation would have statutory powers.
One of the major objections we have to ICSs is that they will lead to increased privatisation. Proposals for this top-down re-organisation include tight financial control from the centre and with even less public accountability. The result will be massive new opportunities for private companies through the ‘Health Systems Support Framework’ (HSSF) – set up to facilitate easy contracting by ICSs. The Framework consists of organisations accredited by NHS England to support the development of internal structure and management of ICSs, and, potentially, also to play a long-term role in direct management of ICSs. A quarter of the 83 organisations approved by NHSE to take on contracts with ICSs, and potentially also take seats on decision-making Boards of ICSs are American-based, offering expensive data-based systems designed to benefit US insurance companies and private hospital chains.
Additionally, NHS England argues that existing law, such as the Health and Social Care Act (2012), does not provide a sufficiently firm foundation for the work of ICSs, so they propose scrapping Section 75 of the Act, which, for example, requires commissioners to put any contract worth over £615,278 out to tender. Removing Section 75, by itself, won’t reverse the marketisation of the NHS. Worse still, it would involve revoking Procurement, Patient Choice and Competition Regulations, so turning the NHS into an unregulated market. The proposals also recommend that NHS services be removed from the scope of the Public Contracts Regulations 2015, allowing commissioners more discretion when procuring services. It means that ICSs would be able to choose whether to award a contract directly to a provider or go through a more formal procurement process. Such flexibility massively increases opportunities for cronyism.
It remains clear that ICSs will be instrumental in further developing privatisation and, indeed, opening up the NHS to very large-scale (ICS-size) takeovers by multinational corporations and institutions.
A second major objection we have to ICSs is the lack of democracy and accountability; there will be little scrutiny by our local Councils and it will be much more difficult to oppose any decisions to ration NHS services or deny access to care. The huge ICS organisation would be more remote from the needs and concerns of any local community. This point has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response (29th December 2020) to the recent consultation states:
“We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. Calling this body an integrated care system is to us a misnomer because it is primarily an NHS body, integrating the local NHS, not the whole health, wellbeing and social care system.”
ICSs will be statutory NHS bodies and, as such, limited in their ability to work in partnership with others, such as with local authorities in addressing health inequalities.  
“In contrast to local authorities, ICSs are not subject to democratic control. NHSE’s proposals will give them the power to create publicly unaccountable joint committees, potentially including representatives from private business, to make legally binding decisions about major resource allocation and service provision….Although ICS Boards will supplant existing public bodies, there appears to be no requirement for them to meet in public, publish their Board papers and minutes, be subject to the Freedom of Information Act, or to have any democratic participation from the communities they cover.”    Keep Our NHS Public comment is here
Thirdly, KONP rejects the assumption, repeated frequently throughout ‘Integrating Care’, that social care might be managed through NHS ICS structures. KONP campaigns for a publicly provided national care and support service. At local level, we argue it is essential that social care continues to be managed by local authorities, retaining essential links to wider local authority responsibilities such as housing, education and leisure.
In its response to NHSE’s proposals, the Local Government Association (the national voice for local government) raises concerns that ICSs won’t be a partnership of equals across the broader health, wellbeing, and social care system. Instead, ICSs will be NHS-led, allowing a power grab that brings LA resources such as capital assets and funding for social care and public health under ICS (and thus NHS) control. There is also a risk that power won’t be devolved to local systems. Rather, central control will remain, with missed opportunities for real collaboration between the NHS and LAs to address the wider determinants of health, such as affordable housing and a safe environment.  Local Government Association response is here
Integrated and caring? Definitely not.
“Our concerns, based on hard facts, are widely shared by councillors, senior NHS management, GPs and seasoned analysts. NHS England’s proposed changes threaten to make the NHS less locally responsive, less accountable, more dominated by US and other management consultants and contractors, and more focused on policing cash limits than meeting the needs of patients. NHS England’s priorities should be on strengthening the NHS in alliance with local government and communities, not creating new remote bodies or adopting systems meant to maximise profits of private health insurance”   National KONP, January 2021
“It is really important to understand that ‘integration’ as in Integrated Care Systems means ‘disintegration’, centralisation, loss of public accountability, opening door wider to private companies, driving down quality to reduce costs, rationing, and a fundamental shift way from a universal service providing comprehensive care to all, free at the point of use”   Dr John Puntis, KONP Co-Chair, 7th February 2021 here
“These proposals are incoherent, de-regulatory, off-target, and badly timed. They will do next to nothing to remedy the serious shortcomings highlighted by the pandemic: a depleted NHS, a privatised social care system, with over-centralised, fragmented and part-privatised communicable disease control and public health systems. Joined-up legislation is needed to revitalise local authorities and to rebuild public services”   Professor Allyson Pollock and Dr Peter Roderick, Newcastle University, 11th February 2021 here
“The NHS is not a ‘religion’, as some would sneeringly suggest, but a hard-won right to receive medical care unconditionally when we are in need. It’s a right that we are losing fast”    Deborah Harrington, Public Matters, 12th February 2021 here



Impact on the pay, terms and conditions of NHS staff

NHS staff

The Health and Care Bill carries significant dangers for the NHS workforce. 
A ‘flexible’ (or malleable) workforce? The ‘flexible working’ envisaged would require NHS staff to move as required, and in some instances rapidly, to different organisations and locations. This could prove highly disruptive for individuals’ working and personal lives, especially bearing in mind the large geographical area most ICSs will cover.
Nor is there any sense of concern that the lack of a stable workforce in any location could not only be hugely stressful but create a barrier to the kind of team building that is fundamental to good patient care and work satisfaction. It’s also a matter of concern that the kind of workforce flexibility expected could serve to undermine effective trade union work and so, over time, pose an indirect threat to employment terms and conditions.
Professional regulation?   What the Bill does include are provisions for deregulation of the professions. And despite a recommendation from NHSE (and in contrast to the Health and Social Care Act of 2012 that ostensibly put clinicians at the centre of planning services), there is no statutory requirement in the Bill for a seat on each ICS Board for a medical or nursing representative.  This absence seems consistent with the Bill’s focus on professional deregulation.
The Bill gives powers to the Secretary of State for Health to use secondary legislation to remove a healthcare profession from regulation, and abolish the regulatory body for that profession.  One of the stated objectives behind this move, outlined in the policy paper Health Care Bill: professional regulation is to support the development of a flexible workforce…..
Pay, terms and conditions?   Insecurity for staff is implied by Schedule 2 of the Bill, which requires each of the 42 ICSs to draw up its own constitution (to be approved by NHSE), setting out how an ICS Board (ICB) will carry out its functions, including how the terms and conditions of its employees will be determined (our emphasis).
Rachael Maskell (MP) picked up this point during the Bill’s second reading, apparently referring to provisions for the transfer of staff when CCGs are abolished. She expressed concern that the proposed legislation would allow an ICS to alter the terms of Agenda for Change (AfC), the national framework for ensuring equal pay for equal work for NHS staff.
The Health and Care Bill will have long-term and worrying implications for the NHS, not least for its staff. It potentially enables new structures and ways of working that will threaten pay, terms and conditions, undermine job satisfaction and patient safety, and devalue skills and experience while weakening professional autonomy and unionisation.
The response has to be total opposition to the Bill.
MANY THANKS to national KONP for the above analysis – the full article is available on the national KONP website here.
An information leaflet for circulation to NHS staff is posted on this page in section 2 “Action” (above)
Click here to watch the 2 min video from Margaret Greenwood MP (Wirral West): “I have put down an amendment to the Health & Care Bill that aims to ensure that the pay rates & T&Cs of Agenda for Change of eligible NHS staff are not undermined as a result of the adoption of the NHS payment scheme”.
From Sharon Graham, UNITE General Secretary (22nd September 2021):
“The government’s new Health & Care Bill is a Trojan horse for more privatisation, cronyism, austerity and a licence for politicians to run down and sell off the NHS. Attempting to drive this through whilst we are still in the middle of a pandemic and without a care for staff and patients is a disgrace, Unite is opposed to this disgraceful bill and we will lead a serious and effective campaign to ensure this bill is stopped. We need you all to act now, wherever you work, whichever sector, community, retired, or young members we need you all to get involved and defeat these plans that will give our NHS to profiteers at the expense of staff and all patients.
If this Bill is passed, all of us will be impacted – we need you all to act now and write to your MP to demand they oppose this Bill. NHS staff and patients will be left in a vulnerable position with this Bill leaving the door wide open for Alternative Provider Medical Services (APMS) to cherry pick services and undermine current working practices. APMS contracts have been described by legal professionals as “the private sector’s gateway to providing primary health care to NHS patients”. They allow companies that are not owned or controlled by medical professionals to run GP surgeries.
This Bill is deeply flawed and creates pathways for health systems that are based on models developed by the private insurance industry in the USA and elsewhere, controlled for profit against patient care. We must not let this Bill pass and destroy the universal and patient care driven service we all cherish.
Our NHS needs investment not more privatisation – help us defeat this Bill and take action now.  Thank you



Impact on local decision-making and democracy in the North East

The North East and North Cumbria integrated care system (ICS) is the largest ICS in the country, covering a 3.5 million population spanning Northumberland, Tyne and Wear, County Durham, Tees Valley and North Cumbria – see map in part 12 (below). There is much concern locally about its size and the Bill says nothing about how “place” based decisions will be made for such a large population. Local participation on the ICS Board and Partnership Board appears to be minimal. In addition, the Secretary of State stands to acquire 138 new powers to intervene in local matters.
There is a real danger that local voices may not be heard at all under the current proposals – it will be much more difficult to oppose any decisions to ration NHS services or deny access to care. Currently, changes to health service provision are discussed and agreed between health, Local Authority and other stakeholders at the local “Health and Wellbeing Board”, and changes are scrutinised by local Councillors sitting on the “Health Scrutiny Committee”. All this will change, with much less input from local Councillors, our elected representatives, and thus decreased local democracy.
The point that huge ICS organisations would be more remote from the needs and concerns of any local community has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response (29th December 2020) to the recent consultation states:
“We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. Calling this body an integrated care system is to us a misnomer because it is primarily an NHS body, integrating the local NHS, not the whole health, wellbeing and social care system.”
The Health Service Journal recently reported (27th July 2021) that 9 councils in Cheshire and Merseyside have recently set up a series of “red lines” and pre-conditions which they say must be met for an integrated care system to be successful. The fact that these Councils in the North West feel the need to set out any “red lines” is an indication that the Bill’s proposals will largely sideline local authorities and should be seen as an attempt by Councillors to ensure genuine collaboration to meet their responsibilities and determine outcomes.
The Lowdown    (20th September 2021)   Gaps in Bill question level of local control
Keep Our NHS Public    (2021)    Local Authority Scrutiny of NHS Provision
Health Service Journal    (27th July 2021)  HSJ- Council Red Lines
British Medical Association    (14th July 2021)    ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill 
The Lowdown    (9th July 2021)     New Health & Care Bill will gag local voices 
Local Government Association    (29th December 2020)       LGA response to NHS England and NHS Improvement consultation on integrated care systems



Opposition to the Health and Care Bill 2021

There has, understandably, been much opposition to the Bill to date and we need this opposition to increase even further, as the Government pushes the Bill through Parliament. This government is not a friend of our NHS. 
Where is the resistance?  It’s right here:    ⇒Keep Our NHS Public  ⇒The BMA    ⇒Open Democracy    ⇒Peoples Assembly    ⇒EveryDoctor    ⇒National Pensioners Convention    ⇒Public Matters    ⇒Socialist Health Association    ⇒999 Call for the NHS    ⇒Health Campaigns Together    ⇒We Own It.    All standing up against the government’s “Corporate Takeover Bill” that would open up our NHS to more privatisation.
Importantly, written evidence was submitted to MPs appointed to examine the Bill during committee stage (late summer / autumn 2021). 83 written submissions were sent to this committee, and these can all be viewed on the UK Parliament website hereClick here  for the KONP submission, written by the national KONP co-chair Dr John Puntis. Submissions are also present from Prof Allyson Pollock and Dr Peter Roderick (Newcastle University), UNISON, BMA, and  the British Association of Social Workers, all of whom highlight specific issues and difficulties with the Bill which will require attention. There are also a number of other key national organisations, charities, not-for-profit organisations and individuals who highlight concerns (….plus a number of organisations and private healthcare organisations – such as Virgin – who appear supportive of the Bill).
Please scroll down to see links to a number of newspaper reports and articles, plus the views of Campaigning organisations.
From the British Medical Association:
14th July 2021:  The British Medical Association (BMA) has “overwhelmingly” voted to oppose the Health and Care Bill ahead of its second reading today. The group, which is the main group representing doctors in the UK, called on MPs to block the bill, warning it poses “significant risks” to the NHS.
See the press release from the BMA here: ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill   (14th July 2021)
See the report in openDemocracy here: Protestors and doctors’ union call on MPs to block new English health bill  (14th July 2021)
and on twitter (14th July 2021):

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From Labour:
14th July 2021:  Shadow Health Secretary Jonathon Ashworth:  “This top down reorganisation allows the private sector a direct say in the design and delivery of local health care. After a year in which cronyism and outsourcing has seen billions wasted on duff PPE and failing contact tracing, patients and staff know this is the last thing the NHS needs. Labour will be fighting NHS privatisation and urging MPs to vote against this bill.”


From MPs:
20th August 2021…..and many thanks to KONPNE supporter Joan Hewitt for sharing this response from Alan Campbell MP (Tynemouth):
Dear constituent,
Thank you for contacting me about the Health and Care Bill 2021-22. I share your concerns that this Bill represents a rushed, top-down reorganisation of our NHS. It will fail to integrate health and social care, erode local accountability, and give powers to the Health Secretary to hand major contracts to the private sector without scrutiny. Along with my colleagues, I voted against the Bill at second reading. The Government says the Bill builds on the NHS’s own proposals for reform, aiming to make it less bureaucratic, more accountable, and more integrated, and that it has incorporated lessons learnt from the pandemic.
Like many in the health sector, I agree with the objective of more integrated health and care services. But I am concerned that this is the wrong Bill at the wrong time. There are widespread concerns that private sector involvement in NHS services has created a fragmented and marketised system. The Health and Social Care Act 2012, which I have consistently opposed, introduced competitive tendering; it requires NHS commissioners to advertise many larger contracts to private firms and it prevents proper integration. The 2012 Act was, in my view, wasteful and it forced privatisation of health services. Instead of this being a simple Bill to end competition and foster local collaboration, I am concerned it allows further outsourcing permitting the private sector to sit on local boards. And it does not reinstate the NHS as the default provider of services.
This is a moment of great pressure on the NHS. Yet there is nothing in the Bill to address the greatest challenges facing the NHS or wider reform of adult social care and workforce pressures. I strongly believe the Government’s focus must instead be on ensuring that services are appropriately staffed and have the resources they need, addressing the crisis in social care, and giving the NHS workforce the pay rise they deserve.
I supported the Opposition’s reasoned amendment to the Bill in an attempt to stop its progress. Disappointingly, Government MPs voted against this amendment, and it was defeated. While I also voted against the Bill at second reading, it passed with the support of Government MPs and will now progress to committee stage.
The NHS is our greatest institution. I am committed to upholding its founding principles as a comprehensive, integrated, and public NHS that is there for all of us when we need it. I will continue to resist any plans to allow further privatisation.
Thank you once again for contacting me about this important issue.
Yours sincerely, Alan Campbell MP


Emma Lewell-Buck MP (South Shields)    @EmmaLewellBuck  The #HealthandCareBill is continuing through Parliament. It is another step in the Tory quest to dismantle and privatise our NHS
emma lewell buck 2
Richard Burgon MP (Leeds East) clearly sets out the situation in a Parliamentary debate  (25th September 2021) – click here to watch a brief 3 min video
and Zara Sultana MP (Coventry South) firmly states the case and stands up for the NHS in her speech (14th July 2021) here

Info, a model letter and MP email address are all in the “Action” section above….Please email now….

From Prof Kailash Chand:
22nd July 2021: Very sadly, the wonderful Prof Kailash Chand OBE, Fellow of the Royal College of GPs, Visiting Professor of Health and Wellbeing, Honorary Vice President of the British Medical Association, Non Exec Director of NHS Greater Manchester very recently passed away – he is very much missed by all who support the NHS.  In one of his final posts he wrote the following ….and we couldn’t agree more…..    (twitter, 22nd July 2021)

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From Unite the Union:


26th July 2021:
Oppose the NHS Bill
“Unite is joining other health unions in calling on MPs to reject the Health and Social Care bill, which received its second reading in the House of Commons on 14 July. The bill brings in widespread legal reforms to the NHS, including reducing its legal duty to provide care and putting power firmly in the hands of big business, at a time when five million people are waiting for treatment and the health service faces a recruitment crisis and a third Covid wave. Under the bill, two statutory bodies – an integrated care board and an integrated care partnership – will be formed, with only one GP being required on the board.   It does nothing to address the chronic under-resourcing and funding, the crisis in social care and a huge shortage of staff”.  



The passage of the Health and Care Bill through Parliament

Parliament 10

> First Reading – 6th July 2021: The Health and Care Bill was introduced in the House of Commons. The First Reading is the first stage of a Bill’s passage through the House of Commons and is a formality; it takes place without debate.
The Bill, plus commentary, is here  (12th July 2021)
House of Commons Research Briefing (12th July 2021) is here
> Second Reading – 14th July 2021: The Second reading is the first opportunity for MPs to debate the main principles of the Bill. The Bill passed its second reading, with Conservative MPs voting for it in a final tally of 359 for and 218 against. This undoubtedly takes us further down the route of a profit-driven, American-style healthcare system – this vote was a shameful move from elected politicians.
Click here to read the Hansard record.
Watch the two-minute video from We Own It here
> Committee Stage – 7th September – 21st October: CURRENT: The Bill is now at the Committee Stage, where detailed examination of the Bill takes place. The committee is able to take evidence from experts and interest groups from outside Parliament. Amendments for discussion are selected by the chairman of the committee and only members of the committee can vote on amendments during committee stage. Every clause in the Bill is agreed to, changed or removed from the Bill. Once the committee stage is finished, the Bill returns to the floor of the House of Commons for its report stage, where the amended Bill can be debated and further amendments proposed. The Committee is expected to report to the House by Tuesday 2 November 2021.
Written evidence may be submitted from outside bodies and individuals, and this evidence is circulated to MPs appointed to examine the Bill during committee stage. 83 written submissions were sent to this committee, and these can all be viewed hereClick here  for the KONP submission, written by the national KONP co-chair Dr John Puntis. Submissions are also present from Prof Allyson Pollock and Dr Peter Roderick (Newcastle University), UNISON, BMA, British Association of Social Workers, plus a number of other key national organisations, charities, not-for-profit organisations, individuals, and private healthcare organisations (such as Virgin).
> Parliamentary process: You can keep track of the Parliamentary process and find more info on the progress of the Health and Care Bill by clicking on the Parliament website here
The Bill still has to proceed through various other parliamentary stages –  in the coming weeks and months we will continue to ramp up our campaign to fight this corporate takeover of our NHS.  General information from the Open University about how a Bill moves through Parliament is here
Scroll down this page for links to newspaper items and reports.




17TH JULY 2021: Forming part of the national Day of Action called by the campaign group “We Own It”, members of “KONP North East” and “KONP Sunderland” met in a very hot and sunny Newcastle city centre, rolled up their sleeves, and demonstrated how the government’s new proposed NHS legislation (The Health and Care Bill 2021) is, in fact, a tug of war between private companies and our NHS in England.  The usual suspects were represented – Centene, Virgin, Serco – plus the local newcomer, Livi, which is a private healthcare company offering virtual appointments in GP practices in North Tyneside….for info, Livi claims to be Europe’s largest digital healthcare provider….currently with a one-year contract in North Tyneside primary care…. (see here) This must be stopped. 
Johnson was also at the Monument, attempting to appease NHS staff with a miserly 1%, and even HRH couldn’t help with the George medal; the medal was appreciated – but it doesn’t pay the bills…..
And our message was, obviously, well-received in the North East.  Huge thanks to people in Newcastle who jumped at the opportunity to join in and clearly knew which tug of war team to join. It is crucial that we continue to join forces to bring an end to the lucrative contracts to healthcare companies which, of course, involves a cut of the cash going to the pockets of shareholders. And, it is also crucial that the professionals who work in our NHS receive a fair wage – the 1% offer is, in short, an insult.
Some street theatre, but with a very serious message. Back in Parliament, the government is pushing ahead with its Health and Care Bill. The NHS needs us more than ever: this legislation includes so many dangerous changes….like letting PRIVATE COMPANIES sit on NHS boards, where they’ll have a say on people’s care and how NHS money is spent ?!?!   Unbelievable – but true.
The NHS has just turned 73 – and if you want it to be with us for another 73 years, then this Bill must be amended. Write to your MP now, sign the petitions, download and share the leaflets: all available above on this page 
We were not alone!! See Tug of War report and photos from across the country here!!




“Integrated Care Systems” (or “Accountable Care Organisations” as they are known in America), an integral part of the Health and Care Act 2021, have no place in our NHS.
These two videos, statements and articles from national “Keep Our NHS Public” and “999 Call for the NHS” clarify the situation we face in 2021….
National Keep Our NHS Public:
“The Bill will break the national NHS into 42 separate “Integrated Care Systems” (ICS), each with its own tight budget forcing cuts in care. Local NHS provision will be tied to a plan written by the ICS Board, open to the private sector, dragging local authorities into a financial project without real democratic accountability or public control. The Bill will be promoted as an end to privatisation. It is the opposite, a transition to an unregulated market in healthcare.”
– National KONP: Statement on the Health and Care Bill 2021 is here
– National KONP: An overview of the Governments White Paper proposals and why we need to campaign against these proposals can be found here
– BBC News: Click here. Keep Our NHS Public’s John Lister on how the Government spin on its white paper is false. The crisis has revealed more and more privatisation and outsourcing plans, not less.
– RT News: Click here. Keep Our NHS Public’s co-chair Tony O’Sullivan on why the Government it really trying to force through NHS reorganisation now, in the middle of the pandemic. And reversing privatisation is not the reason. 
– Many thanks to KONPNE Steering Group member John Kennedy, who has brought together some of the main themes, proposals and questions in his paper here.
8th September 2021:
Watch PROTECT THE NHS – SCRAP THE HEALTH AND CARE BILL –  the national KONP online rally, part of the fight-back against Bill.
What a line up!  Julie Hesmondhalgh, Actor, Michael Rosen, Writer, Dr Tony O’Sullivan (KONP), Jonathan Ashworth MP Shadow Secretary of State for Health, Alia Butt (NHS Staff Voices), Steve Cowan, Council Leader, Mark Ladbrooke, Chair Socialist Health Association, Cat Hobbs, Director of We Own It, Holly Turner (NHS Workers Say No), Dr Philippa Whitford MP (SNP), Dr David Wrigley (BMA), Dr Sonia Adesara (KONP), John Lister, Health Campaigns Together.

999 Call for the NHS:

999 callfornhs1

We Own It   (7th April 2021)    More privatisation, less accountability – this government’s plans for the NHS
National KONP (18th February 2021)    2021 NHS White Paper: government seizes on the pandemic as an opportunity
National KONP (6th February 2021)   Government used crisis to increase privatisation – NHS white paper will endorse
National KONP (January 2021)    Integrated Care Systems Summary Briefing
National KONP  Integrated Care Systems: The threat to the NHS, social care and public health
Click here for many links to articles about ICSs at “The Lowdown.” 
999 Call for the NHS (January 2021)  Integrated Care – the US Danger
999 call for the NHS (7th January 2021)  We say NO! to proposed NHS legislation that would restrict access to care and profit global companies



National KONP responds to the Government

Keep Our NHS Public was provided with an opportunity to present evidence on the proposals put forward in the Government’s White Paper “Integration and Innovation: working together to improve health and social care”, which was the forerunner to the Bill. Here is what National KONP said to Parliament. 
We have a number of concerns about these proposals, namely:
– The risk of a democratic deficit
– Increased central control despite assurances of more local decision making
– The risk of prioritising constraint over collaboration
– A shift of focus for the NHS from the provision of universal, comprehensive care towards ‘demand’ management
– The risk that mere lip service will be given to redressing health inequalities
– The increased presence and influence of private companies facilitated by Integrated Care Systems
– The implications of repealing Section 75 of the Health and Social Care Act (2012) without dismantling the market in NHS services
– The emphasis on deregulation at the risk of cronyism
– New arrangements that will fragment and deskill the NHS workforce, with the possibility of deregulating some professions in future
To read the entire document of evidence submitted by KONP





LINKS – newspaper items, opinion pieces, reports 

The Lowdown    (2nd October 2021)   Exploring flaws in the Health and Care Bill
999 Call for the NHS    (23rd September 2021)   Health Minister’s Health and Care Bill anti-privatisation amendment is a dead cat
The Lowdown    (20th September 2021)   Gaps in Bill question level of local control
The Lowdown    (20th September 2021)   U turn: No private firms to sit on new Integrated Care Boards
The Lowdown    (15th September 2021)   Sources say no private firms on ICS boards
National KONP    (15th September 2021)    The Health & Care Bill and the new NHS Data Grab
The Lowdown    (9th September 2021)   Health and care bill takes deep flaws into committee stage
We Own It    (9th September 2021)    The BMA’s Dr Chaand Nagpaul just explained really simply why private companies sitting on NHS boards is such a bad idea.  
Keep Our NHS Public    (17th August 2021)    The Health and Care Bill and what it means for the pay, terms and conditions of NHS staff
Byline Times    (17th August 2021)   THE CORPORATE TAKEOVER OF THE NHS: What Does ‘Privatisation’ of Health Services Really Mean?
Health Service Journal    (12th August 2021)   Change the Health Bill to strengthen governance and democracy 
“Just Treatment” video   (20th July 2021)    Tania and Amy’s Story
999 Call for the NHS    (16th July 2021)     US Health Insurance Provider in prime position to take over new NHS Integrated Care Systems
BMA (14th July 2021)     ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill    
openDemocracy   (14th July 2021)    Protestors and doctors’ union call on MPs to block new English health bill
The Guardian   (14th July 2021)   Proposed reforms to NHS ‘institutionalise cronyism’, claims Labour 
The National    (14th July 2021)     Health and Care Bill: NHS ‘takeover’ legislation passes second reading
Allyson Pollock website   (13th July 2021)    Key points and questions for the Second Reading
Also here: Key points and Questions re Bill from Prof Allyson Pollock and Dr Peter Roderick    (13th July 2021)    Click here
999 Call for the NHS    (13th July 2021)      Health and Care Bill – key points and questions ahead of 14 July second reading
openDemocracy    (13th July 2021)     Forget the spin – new English NHS bill is all about cutting our right to healthcare
The Lowdown    (9th July 2021)    New Health & Care Bill will gag local voices
Mirror    (6th July 2021)    Tory health bill published today despite fears it puts ‘private firms at heart of NHS’
The Guardian    (6th July 2021)   Health bill could see NHS contracts awarded without tender process
Guardian   (4th July 2021)   Johnson to announce controversial plans for greater NHS control
The Lowdown    (28th June 2021)    Tory splits on Health Bill
The Lowdown    (28th June 2021)     NHS Reorganisation – a never ending story
Letter from Margaret Greenwood MP to Matt Hancock (11th June 2021) is here
The Lowdown   (28th May 2021)    Virgin given seat on ICS Board
Leading Health Care    (4th January 2021)     Professor Sir Liam Donaldson appointed Chair for the Integrated Care System for the North East and North Cumbria
We Own It    (11th May 2021)     16 organisations call for NHS Bill to be halted
Socialist Health Association    (10th May 2021)   Centene: The real agenda
Bright Green   (27th March 2021)    Matt Hancock’s proposals for our NHS are bad news
Private Eye   (March 2021)   A Practice Run
The Lowdown   (21st March 2021)     Bleak prospects for troubled ICSs
Laura Murrell, Secretary, KONP Sunderland and District re “Consultation”   Click here  (obviously some “consultation” responses are more equal than others…..)
Twitter (16th March 2021)  Hancock talking about ‘the false dichotomy’ between public and private… and equating GPs with companies like Virgin   Click here
The Lowdown (6th March 2021)   Can campaigners unite over coming health Bill?
Labour Outlook   (26th February 2021)     Hancock’s NHS plans would see the ramping up of privatisation on a scale we’ve never seen before
The Lowdown  (24th February 2021)    The great consultancy boom – from Covid to ICSs
The Canary (16th February 2021)    The reasons why Matt Hancocks proposed NHS reforms should worry us all 
Tribune (12th February 2021)   The Next NHS Sell-Off
British Medical Journal (11th February 2021)   A new bill to reform the NHS in England: the wrong proposals at the wrong time     (Prof Allyson Pollock and Dr Peter Roderick)
Stewart Player, National KONP (2021)    Integrated care or healthcare imperialism?
Guardian (11th February 2021)  Matt Hancock to publish plans to give ministers more power over NHS
Mirror (11th February 2021)  Tories unveil plans today to unpick their own disastrous NHS reforms
Dr John Lister: “We have another massive top-down reorganisation which retains the fragmentation and chaos of outsourcing…leaves huge contracts to be allocated without any competition”
Morning Star (11th February 2021)    All spin and no substance in Tories’ health and social-care plan, Unions and NHS campaigners warn
rs21 (10th February 2021)    Are the Tories really reversing NHS privatisation?
Institute for Government (8th February 2021)   Leaked NHS reforms would take us back to the wrong sort of future
The Lowdown (9th February 2021)  White Paper: power grab, sea change or cementing in the status quo?
Duncan Poundcake (5th February 2021)    #NHS Not all Privatisations are equal, some are worse and some are Evil…
Health Service Journal (27th January 2021)  CCG mergers must still go ahead in April, says NHS England
The Lowdown (8th January 2021)   Councils concern about NHS shakeup
Chronicle (17th December 2020)  City leaders back groundbreaking new partnership to transform health and social care services
CK 999 Call for the NHS (14th December 2020)    US companies poised to run NHS following proposed legislation
The Lowdown (6th December 2020)    NHS England pushes for “integration” … but not as we know it
KONP (10th December 2020)   Dangerous NHS restructuring to go ahead despite Covid
The Guardian: Years of underfunding leave NHS ‘woefully short’ for Covid second wave   (5th November 2020)
CCG mergers > ICSs: The Lowdown (September 28th 2020)
Who’s cashing in on ICS’s?    The Lowdown (October 12th 2020)
CK999 Call for the NHS (2nd February 2019)    What changes will patients notice when the NHS is run by Integrated Care Systems and Providers?

Further detailed analysis of the ICS proposals is given in the three part National KONP document (January 2021) linked below:
  • Part 1: Corporate Agenda for Integrated Care  on the themes running through NHSE’s ‘Integrating Care’ including the use of digital and data to drive system working, reform of the NHS payment system, and the influence of multi-national corporates through the NHSE’s Health Systems Support Framework (HSSF);  
All documents are linked here




KONPNE Briefing Papers (October 2019)
These two Briefing Papers are for use by all members of the public – copies were sent to all Councillors in the NE in October 2019 …. they were warned….
Accountable Care Organisations and Integrated Care Systems        2019 KONPNE briefing – ACO and ICS

2019 KONPNE briefing - ACO and ICS-page0001 (5)

We need to be worried about the NHS Long Term Plan, Integrated Care Systems and Primary Care Networks          2019 KONPNE briefing – We Need To Be Worried

2019 KONPNE briefing - We Need To Be Worried-page0001 (3)






> ICS Strategic Five Year Plan: Presentation by Mark Adams to the Councils’ Joint Overview and Scrutiny Committee (20th January 2020) is here
> Map of the North East and North Cumbria Integrated Care System (NENC ICS). This is sub-divided into four Integrated Care Partnerships (ICPs) , with each Partnership area being divided further into places:

ICS Boundary-Maps-Oct-2019

From North Tyneside CCG Annual Report 2020/21, page 12 (here):
“The keystone of the wider, regional strategic work is that of the Integrated Care System (ICS). In June 2019, the North East and North Cumbria area was confirmed by NHS England as an ICS.  The North East and North Cumbria Integrated Care System (ICS) is a regional partnership between the NHS, local authorities and others, taking collective responsibility for resources, setting strategic objectives and care standards, and improving the health of the 3.1million people it serves. Our ICS is a collaboration of NHS commissioners and providers, and our partners, and not a new organisation with statutory powers. This is set to change in the future, following the publication by the Government on 11 February 2021 of a new White Paper called “Integration and Innovation: working together to improve health and social care for all”. Work has started to understand the impacts of this White Paper and this will continue at pace during 2021/22. However, the ICS will take on formal status with statutory powers”







long term plan 2019

This far-reaching, top-down reorganisation of the NHS is based on the proposals in the Long Term Plan – click here for details



Screenshot (189)

Click on these two links to read the initial Government proposals….
Statement by the Secretary of State for Health and Social Care, setting out the government’s white paper on the future of health and care (11th February 2021):  Click here to read the statement The future of health and care”
White paper setting out legislative proposals for a Health and Care Bill: Click here to read the White Paper “Integration and Innovation: Working together to improve health and social care for all”
Here  is a standard letter format to send to MPs, written to call an end to the roll out of Integrated Care Systems – events have overtaken this, and it is now more helpful to lobby MPs to stop the Health and Care Bill, but the contents of the letter remain very useful and, thus, the letter is left here for information. 


….and the NHS “CONSULTATION” ON INTEGRATED CARE SYSTEMS (2020/21) – the “Consultation” that never was….

NHS England

NHS England (NHSE) maintains that it has recently (Dec 2020, Jan 2021) “consulted” on their latest plans for ‘integrating care’, including changes to legislation.
Have members of the public had a fair opportunity to get involved??  We think not.
Below are documents devised by the national KONP ICS Working Group; this useful information was in response to the consultation and are filed here for future reference:
KONP objections to legislative changes: KONP-ICS-legislation-proposals-responses-2021-01-03
Model responses to the consultation questions from national KONP:  KONP-ICS-consultation-model-responses-2021-01-03 (2)




Remember them?  For information about the forerunners to the Integrated Care System, click here