Health unions have condemned the latest shake up of the NHS, which will include the abolition of strategic health authorities.
Unision expressed dismay at what it described as a "dismal" Queen’s Speech this morning, and attacked an announcement by health secretary Andrew Lansley that SHAs will be scrapped by April 2012.
Last week’s 30 page document setting out the Conservative-Liberal Democrat plan for government confirmed there will be a new round of structural change in the NHS, triggered by the combination of the pledges in the two parties’ manifestos.
The document said the Department of Health will be slimmed down and an NHS board set up, that quangos such as Monitor and the Care Quality Commission will be given new roles, and that GPs will take over most commissioning.
The document gave the job of planning and commissioning in "wider areas" to primary care trusts and failed to allocate a role to SHAs. Some of the changes will require the legislation that will be brought forward in the health bill.
However, Unison said the measures outlined in the Queen’s Speech would "break up" the NHS and education and pave the way for more private sector involvement in both.
Unision head of health Karen Jennings said it was also "very concerned" about plans to scrap SHAs, since they played a key role in co-ordinating the response to issues such as swine-flu, monitoring standards, and overseeing workforce issues.
SHAs also have a role in NHS IT, since they work with NHS Connecting for Health and oversee the IT plans that trusts have to draw up in response to the annual operating framework.
Some SHAs, such as NHS Yorkshire and the Humber, have also taken an active role in drawing up framework contracts that trusts can call on when they want to undertake technology projects.
“The Treasury will be forced to reinvent these authorities, as they can not allow hundreds of trusts to function without financial scrutiny and it is impractical to do this centrally," Jennings argued.
“We are calling on the government to explain how commissioning and monitoring and non-foundation trusts will be co-ordinated without the huge expansion of another quango.”
The detail of the Queen’s Speech says the health bill will include measures to replace the "top down" NHS with more "power and responsibility" for doctors and patients, and to create a new public health service.
Targets with "no clinical justification" will be scrapped and a new cancer drug fund created with the £200m that the NHS will not need to spend if the rise in National Insurance contributions announced by the last government does not go ahead.