MP calls for full parliamentary scrutiny of Accountable Care Organisations to protect the future of NHS and care services

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11 Jan 2018

Wirral West MP Margaret Greenwood has called for full public and parliamentary scrutiny of the introduction of Accountable Care Organisations to run NHS and social care services.

Margaret Greenwood spoke out in Parliament about government plans to bring in major changes to how health and social care is delivered at local level.

In a debate in the House of Commons she highlighted some of the risks of introducing Accountable Care Organisations (ACOs) to run health and social care.

Accountable Care Organisations are non-NHS bodies that would manage very substantial budgets amounting to hundreds of millions of pounds for the delivery of health and social care at local level.

There are plans for an Accountable Care System (ACS) to be introduced in Wirral this April, and, if it goes ahead, this would be finalised by April 2019. Once an ACS is set up, it could be turned into an ACO. Both entities are also sometimes referred to as 'place-based care'.

Margaret Greenwood raised concerns that ACOs might be run by private providers, rather than publically open and accountable bodies.

She also spoke of other issues relating to Accountable Care Organisations, including the blurring of boundaries between health and social care, the drive to reduce costs in the system, and the consequent risk of increased rationing and the introduction of charges for certain aspects of healthcare, with certain treatments potentially being made unavailable unless patients pay.

Speaking after the debate, she said:

"I am extremely concerned that the government is seeking to provide the necessary legal framework for Accountable Care Organisations through secondary legislation, bypassing debate in the House of Commons.

"There are important questions that the government must answer in relation to ACOs before they are allowed to go ahead.

"Full Parliamentary and public scrutiny is essential.

"We have yet to have any clarity from Jeremy Hunt over who will be allowed to run them.
"Will they be private companies? Could they be big American corporations?
"We know that Jeremy Hunt believes the American commercial healthcare provider Kaiser Permanente to be one of the best examples of practice in integrated care, so it is reasonable to be concerned that he would like to introduce that here.

"Kaiser Permanente provide private health insurance to individuals. I am absolutely certain that people in Wirral West do not want to move from the National Health Service to a private individual insurance-based healthcare system. It would be extremely costly for individuals and anyone with serious pre-existing conditions may struggle to get insurance at all.

"We all value our NHS highly. I believe it is essential the government allows full public and Parliamentary scrutiny of these plans before they go any further."

You can find the speech by Margaret Greenwood MP in the House of Commons at

There are currently two groups bringing judicial reviews in relation to accountable care organisations. You can find more information on that at

The Health Select Committee is carrying out an inquiry into Sustainability and Transformation Partnerships and includes Accountable Care Systems within its Terms of Reference.

When asked whether this would mean that Accountable Care Organisations sit outside the Terms of Reference, the Clerk to the Committee has said that at this point, essentially there is no difference between them.