The Department of Health and Social Care (DHSC) is a
department of
His Majesty's Government
ga, Rialtas a Shoilse gd, Riaghaltas a Mhòrachd
, image = HM Government logo.svg
, image_size = 220px
, image2 = Royal Coat of Arms of the United Kingdom (HM Government).svg
, image_size2 = 180px
, caption = Royal Arms
, date_est ...
responsible for government policy on
health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
and adult
social care
Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social wor ...
matters in England, along with a few elements of the same matters which are not otherwise
devolved
Devolution is the statutory delegation of powers from the central government of a sovereign state to govern at a subnational level, such as a regional or local level. It is a form of administrative decentralization. Devolved territories h ...
to the
Scottish Government,
Welsh Government
The Welsh Government ( cy, Llywodraeth Cymru) is the Welsh devolution, devolved government of Wales. The government consists of ministers and Minister (government), deputy ministers, and also of a Counsel General for Wales, counsel general. Minist ...
or
Northern Ireland Executive
The Northern Ireland Executive is the devolved government of Northern Ireland, an administrative branch of the legislature – the Northern Ireland Assembly. It is answerable to the assembly and was initially established according to the ter ...
. It oversees the
English National Health Service
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the ...
(NHS). The department is led by the
secretary of state for health and social care
The secretary of state for health and social care, also referred to as the health secretary, is a secretary of state in the Government of the United Kingdom, responsible for the work of the Department of Health and Social Care. The incumbent ...
with three
ministers of state
Minister of State is a title borne by politicians in certain countries governed under a parliamentary system. In some countries a Minister of State is a Junior Minister of government, who is assigned to assist a specific Cabinet Minister. In o ...
and three
parliamentary under-secretaries of state.
The department develops policies and guidelines to improve the quality of care and to meet patient expectations. It carries out some of its work through
arms-length bodies (ALBs), including executive
non-departmental public bodies
In the United Kingdom, non-departmental public body (NDPB) is a classification applied by the Cabinet Office, Treasury, the Scottish Government and the Northern Ireland Executive to public sector organisations that have a role in the process of na ...
such as
NHS England and the
NHS Digital
NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly th ...
, and
executive agencies
An executive agency is a part of a government department that is treated as managerially and budgetarily separate, to carry out some part of the executive functions of the United Kingdom government, Scottish Government, Welsh Government or Nor ...
such as the
UK Health Security Agency
The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability, and replacing Public Health England. It is an executiv ...
and the
Medicines and Healthcare products Regulatory Agency (MHRA). The DHSC also manages the work of the
National Institute for Health and Care Research
The National Institute for Health and Care Research (NIHR) is the British government’s major funder of clinical, public health, social care and translational research. With a budget of over £1.2 billion in 2020–21, its mission is to "impr ...
(NIHR).
The expenditure, administration and policy of the department are scrutinised by the
Health and Social Care Select Committee
The Health and Social Care Select Committee (abbreviated to HSC, HSCC and HSCSC) is a Departmental Select Committee of the British House of Commons, the lower house of the United Kingdom Parliament. Its remit is to examine the policy, administra ...
.
According to
David Nicholson it's attractive to politicians because "Its the largest toy train set in Europe."
History
Like many others, the department with responsibility for the nation's health has had different names and has included other functions at different times.
In the 19th century, several bodies were formed for specific consultative duties and were dissolved when they were no longer required. There were two incarnations of a Board of Health, in 1805 and 1831, and from 1854 to 1858 a General Board of Health reported directly to the
Privy Council
A privy council is a body that advises the head of state of a state, typically, but not always, in the context of a monarchic government. The word "privy" means "private" or "secret"; thus, a privy council was originally a committee of the mon ...
. Responsibility for health issues was also in part vested in
local health boards, which existed from 1848 to 1894. In 1871, the
Local Government Board
The Local Government Board (LGB) was a British Government supervisory body overseeing local administration in England and Wales from 1871 to 1919.
The LGB was created by the Local Government Board Act 1871 (C. 70) and took over the public health a ...
was created to supervise such local functions as health and sanitation and also took over the functions of the
Poor Law Board The Poor Law Board was established in the United Kingdom in 1847 as a successor body to the Poor Law Commission overseeing the administration of the Poor Law Amendment Act 1834. The new body was headed by a President, and with the Lord President of ...
, which was abolished. The
Public Health Act 1875 designated
sanitary district
Sanitary districts were established in England and Wales in 1872 and in Ireland in 1878. The districts were of two types, based on existing structures:
*Urban sanitary districts in towns with existing local government bodies
*Rural sanitary dis ...
s, which by the
Local Government Act 1894
The Local Government Act 1894 (56 & 57 Vict. c. 73) was an Act of the Parliament of the United Kingdom that reformed local government in England and Wales outside the County of London. The Act followed the reforms carried out at county level un ...
became rural and urban district councils. With the emergence of modern local government, some of its supervision was done by the Local Government Act Office, part of the Home Office.
The
Ministry of Health Act 1919
The Ministry of Health Act 1919 was an Act of Parliament which established for the first time in the United Kingdom a Minister of Health.
It also established the Consultative Council on National Health Insurance, the Consultative Council on Med ...
abolished the Local Government Board and transferred its powers and duties to a new department called the Ministry of Health, which consolidated under a single authority the medical and public health functions of central government. This took on the medical duties of the
Board of Education
A board of education, school committee or school board is the board of directors or board of trustees of a school, local school district or an equivalent institution.
The elected council determines the educational policy in a small regional are ...
, the duties of the Privy Council under the Midwives Acts, the powers of the Home Secretary in relation to the
Children Act 1908, and the duties of the Insurance Commissioners and the Welsh Insurance Commissioners. In the early part of the 20th century, medical assistance had been provided through these National Health Insurance Commissions. Most of the Local Government Board staff transferred to the new ministry.
The co-ordination of local medical services was expanded in connection with emergency and wartime services, from 1935 to 1945, and these developments culminated in the establishment of the
NHS
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in 1948.
In 1968, the Ministry of Health was dissolved and its functions transferred (along with those of the similarly dissolved Ministry of Social Security) to the newly created
Department of Health and Social Security
The Department of Health and Social Security (commonly known as the DHSS) was a ministry of the British government in existence for twenty years from 1968 until 1988, and was headed by the Secretary of State for Health and Social Services.
Hi ...
(DHSS). Twenty years later, in 1988, these functions were split back into two government departments, forming the
Department of Social Security
The Department of Social Security (DSS) was a governmental agency in the United Kingdom from 1988 to 2001. The old abbreviation is still often used informally. Advertisements for rented accommodation used to describe prospective tenants who wou ...
(DSS) and the Department of Health, formally created in through The Transfer of Functions (Health and Social Security) Order 1988.
After the
2018 British cabinet reshuffle
Theresa May carried out the first reshuffle of her minority government in January 2018. Following the resignation of her deputy, Damian Green as First Secretary of State in December 2017, the reshuffle had been highly anticipated and briefed in ...
, the department was renamed the Department of Health and Social Care.
Location
The department's headquarters and ministerial offices are at 39
Victoria Street,
London
London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
. The department moved from its previous location in
Richmond House
Richmond House is a government building in Whitehall, City of Westminster, London. Its name comes from an historic townhouse of the Duke of Richmond that once stood on the site.
History Stewart Dukes of Richmond
Richmond House was first built ...
, Whitehall in November 2017. Its other principal offices are
Skipton House
Skipton House is a high specification office building in Elephant and Castle, Central London.
It was built for a Japanese bank and then sold on to accommodate staff of the Department of Health who were moved out of Alexander Fleming House. T ...
(
Elephant and Castle
The Elephant and Castle is an area around a major road junction in London, England, in the London Borough of Southwark. The name also informally refers to much of Walworth and Newington, due to the proximity of the London Underground station ...
), Wellington House near
Waterloo station
Waterloo station (), also known as London Waterloo, is a central London terminus on the National Rail network in the United Kingdom, in the Waterloo area of the London Borough of Lambeth. It is connected to a London Underground station of t ...
and
Quarry House
Quarry Hill is an area of central Leeds, West Yorkshire, England. It is bounded by the Leeds Inner Ring Road in the east and north and the Leeds – York / Hull railway in the south. The area falls within the City and Hunslet ward of Leeds Ci ...
in
Leeds
Leeds () is a city and the administrative centre of the City of Leeds district in West Yorkshire, England. It is built around the River Aire and is in the eastern foothills of the Pennines. It is also the third-largest settlement (by populati ...
. Wellington House is now mainly occupied by staff from the department's arms-length bodies. New King's Beam House near
Blackfriars Bridge
Blackfriars Bridge is a road and foot traffic bridge over the River Thames in London, between Waterloo Bridge and Blackfriars Railway Bridge, carrying the A201 road. The north end is in the City of London near the Inns of Court and Temple Ch ...
was formerly a Department of Health office prior to the expiry of its lease in October 2011.
Alexander Fleming House
Metro Central Heights is a group of residential buildings in Walworth in the London Borough of Southwark. It was originally known as Alexander Fleming House, a multi-storey office complex designed by Hungary, Hungarian-born modernist architect E ...
,
Hannibal House and Eileen House (all in Elephant and Castle) were previously used by the department. The archives are at
Nelson
Nelson may refer to:
Arts and entertainment
* ''Nelson'' (1918 film), a historical film directed by Maurice Elvey
* ''Nelson'' (1926 film), a historical film directed by Walter Summers
* ''Nelson'' (opera), an opera by Lennox Berkeley to a lib ...
, Lancashire.
Ministers
there are 6 ministerial posts at the DHSC, including: the
Secretary of State, two
Ministers of State
Minister of State is a title borne by politicians in certain countries governed under a parliamentary system. In some countries a Minister of State is a Junior Minister of government, who is assigned to assist a specific Cabinet Minister. In o ...
, and three
Parliamentary Under-Secretaries of State.
The ministers are as follows:
Permanent secretary
The
permanent secretary
A permanent secretary (also known as a principal secretary) is the most senior Civil Service (United Kingdom), civil servant of a department or Ministry (government department), ministry charged with running the department or ministry's day-to-day ...
at the Department of Health and Social Care is
Sir Christopher Wormald KCB, who was appointed in 2016.
Previous permanent secretaries:
*
Dame Una O'Brien 2010–2016
*
Sir Hugh Taylor KCB 2006–2010
* Sir
Nigel Crisp KCB 2000–2006
*
Sir Christopher Kelly
Sir Christopher William Kelly, KCB (born 18 August 1946) is a former senior British Civil Servant who was the Chairman of the Committee on Standards in Public Life and Chairman of the NSPCC.
Early life
Born in Bromley, Kent, Kelly is the son of ...
KCB 1997–2000
*
Sir Graham Hart KCB 1992–?
*
Sir Christopher France GCB (DHSS including social security: 1987–1988, DH: 1987–1992)
*
Sir Kenneth Stowe GCB CVO 1981–1987 (DHSS)
Following the resignation of Sir Nigel Crisp in March 2006, a separate post of
Chief Executive of the National Health Service in England
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the ...
was created, held by
Sir David Nicholson
Sir David Nicholson is a public policy analyst, forthcoming Chair of Sandwell and West Birmingham NHS Trust, current Chair of Worcestershire acute hospitals NHS trust and NHS manager who was Chief Executive of the National Health Service in En ...
. Following the
Health and Social Care Act 2012
The Health and Social Care Act 2012c 7 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date.'' BMJ'', 2011; 342:d408Dr Lansley's M ...
and the creation of the independent NHS Commissioning Board, known as
NHS England, this post has evolved into Chief Executive of the new organisation.
Chief professional officers
The department has six chief professional officers who provide it with expert knowledge and also advise the Ministers, other government departments and the
Prime Minister
A prime minister, premier or chief of cabinet is the head of the cabinet and the leader of the ministers in the executive branch of government, often in a parliamentary or semi-presidential system. Under those systems, a prime minister is not ...
. The Chief Medical Officer and Chief Nursing Officer are also directors of the department's board.
Arms-length bodies (ALBs)
The department acts as a 'steward' for the health and adult social care system in England and oversees fifteen
arms-length bodies (ALBs):
Executive agencies
The department has two
executive agencies
An executive agency is a part of a government department that is treated as managerially and budgetarily separate, to carry out some part of the executive functions of the United Kingdom government, Scottish Government, Welsh Government or Nor ...
:
* The
Medicines and Healthcare products Regulatory Agency has the specialist role of assessing, licensing and regulating medicines and medical devices for use in the United Kingdom.
* Until April 1, 2021,
Public Health England
Public Health England (PHE) was an executive agency of the Department of Health and Social Care in England which began operating on 1 April 2013 to protect and improve health and wellbeing and reduce health inequalities. Its formation came as a ...
was responsible for delivering public health improvement through prevention and awareness raising and protection. It was replaced by a new agency
UK Health Security Agency
The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability, and replacing Public Health England. It is an executiv ...
since April 2021, and became fully operational in October 2021.
Executive non-departmental public bodies
The department has thirteen executive
non-departmental public bodies
In the United Kingdom, non-departmental public body (NDPB) is a classification applied by the Cabinet Office, Treasury, the Scottish Government and the Northern Ireland Executive to public sector organisations that have a role in the process of na ...
:
;United Kingdom
* The
Human Tissue Authority
The Human Tissue Authority (HTA) is an executive non-departmental public body of the Department of Health and Social Care in the United Kingdom. It regulates the removal, storage, use and disposal of human bodies, organs and tissue for a number ...
regulates the use of human tissue in research and therapeutic treatments across the United Kingdom.
* The
Human Fertilisation and Embryology Authority
The Human Fertilisation and Embryology Authority (HFEA) is an executive non-departmental public body of the Department of Health and Social Care in the United Kingdom. It is a statutory body that regulates and inspects all clinics in the United ...
, which regulates and inspects in vitro fertilisation, artificial insemination and the storage of human eggs, sperm or embryos. It also regulates human embryo research.
;England and Wales
*
NHS Blood and Transplant
NHS Blood and Transplant is an executive non-departmental public body of the United Kingdom's Department of Health and Social Care.
It was established on 1 October 2005 to take over the responsibilities of two separate NHS agencies: UK Transplan ...
, which is responsible for the supply of blood, organs, tissues and stem cells; their donation, storage and transportation.
* The
National Institute for Health and Care Excellence
The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health and Social Care in England that publishes guidelines in four areas:
* the use of health technologies withi ...
(NICE), which provides advice on treatment procedures and assesses healthcare interventions for cost-effectiveness.
* The
NHS Business Services Authority
The NHS Business Services Authority (NHSBSA) is an executive non-departmental public body of the Department of Health and Social Care which provides a number of support services to the National Health Service in England and Wales. It was create ...
provides business support services to NHS organisations, including the administration of the NHS pension scheme.
;England only
* The
Care Quality Commission
The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. It was established in 2009 to regulate and inspect health and social care services in England.
I ...
(CQC) has the primary function of inspecting providers of health and adult social care in England, ensuring that they meet essential standards of safety and quality.
*
NHS Digital
NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly th ...
, which provides statistical information and informatics support to the health and care system in England.
*
Health Education England
Health Education England (HEE) is an executive non-departmental public body of the Department of Health and Social Care. Its function is to provide national leadership and coordination for the education and training within the health and public h ...
is responsible for ensuring enough high-quality training is available to develop the healthcare workforce.
*
NHS England oversees the NHS in England, commissions specialised healthcare services and primary care services and oversees
clinical commissioning group
Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022 they were abolished and replaced by Integ ...
s and as of 1 April 2019 (formalised in June 2022,) oversees
NHS trust
An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
s and
foundation trust
A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the abolition of SHAs in 2013, their local s ...
s in England, due to a merger with
NHS Improvement
NHS Improvement (NHSI) was a non-departmental body in England, responsible for overseeing the National Health Service's foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care. It supported providers t ...
which itself was only formed in April 2016 by combining:
**
Monitor
Monitor or monitor may refer to:
Places
* Monitor, Alberta
* Monitor, Indiana, town in the United States
* Monitor, Kentucky
* Monitor, Oregon, unincorporated community in the United States
* Monitor, Washington
* Monitor, Logan County, West ...
, which oversaw
foundation trust
A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the abolition of SHAs in 2013, their local s ...
s and applications from NHS trusts seeking foundation trust status. It also had the new role of examining pricing and competition in the NHS.
** The
NHS Trust Development Authority
The NHS Trust Development Authority (NHSTDA) was an executive non-departmental public body of the Department of Health. Its formation came as a result of reorganisation of the National Health Service (NHS) in England outlined in the Health and Soci ...
had the function of helping
NHS trust
An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
s achieve successful applications for foundation trust status.
* The
Health Research Authority
The Health Research Authority (HRA) is an arm’s length body of the Department of Health and Social Care (DHSC) in England. The HRA exists to provide a unified national system for the governance of health research. The current chair of the HRA is ...
protects and promotes the interests of patients and the public in health research.
*
NHS Resolution
NHS Resolution, the operating name of NHS Litigation Authority, is an arm's length body of the Department of Health and Social Care. It changed its name in April 2017.
The organisation's purpose is to provide expertise to the NHS on resolving c ...
, handles negligence claims and helps the NHS learn lessons from claims to improve patient and staff safety.
* The
NHS Counter Fraud Authority, tasked with leading the fight against NHS Fraud and corruption.
Criticism
Introduction of user charges for NHS services
The publication of
Professor Lord Darzi's review of the NHS
prompted criticism of the government and the Department of Health, claiming that it paved the way for user charging,
and so contradicting the
NHS Plan 2000
The NHS Plan 2000 was a ten year plan of the Blair ministry for the National Health Service (England). It combined a commitment to substantial investment with some quite radical changes. The most controversial aspect of the plan was the introducti ...
which stated that "user charges are unfair and inequitable in they increase the proportion of funding from the unhealthy, old and poor compared with the healthy, young and wealthy".
The report also introduces the concept of
personal budgets.
Fragmentation of NHS services
Darzi's report
splits previously integrated services into 'core', 'additional' and 'enhanced' services, which critics say will lead to abandoning the open-ended duty of care on which the NHS was founded.
"Superbugs" and PFI
Fatal outbreaks of
antibiotic-resistant
Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. All classes of microbes can evolve resistance. Fungi evolve antifungal resistance. Viruses evolve antiviral resistance. ...
bacteria
Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among ...
("superbugs"), such as
methicillin-resistant ''Staphylococcus aureus'' (MRSA) and ''
Clostridium difficile'', in NHS hospitals has led to criticism in 2008 of the department's decision to outsource cleaning via
private finance initiative
The private finance initiative (PFI) was a United Kingdom government procurement policy aimed at creating "public–private partnerships" (PPPs) where private firms are contracted to complete and manage public projects. Initially launched in 199 ...
contracts as "cutting corners on cleaning".
A "Deep Clean" initiative announced by the Department of Health was criticised by infection control experts and by the Lancet as a gimmick which failed to address the causes of in-hospital infections, by the firms doing the work as an attempt to avoid paying for regular better cleaning,
and by NHS managers as ineffective.
It also attracted criticism because only a quarter of the £60m funding for the scheme went to hospitals, and because a number of hospitals missed the completion target,
and as of June 2008 one in four NHS trusts was not meeting the government's standards on hygiene.
Prescribing
Its advice to primary care on prescribing drugs such as
proton pump inhibitors
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump.
They are the most potent inhibitors ...
has been criticised as wasteful.
Medical training
The DH has attracted criticism for its handling of the outcome of
Modernising Medical Careers Modernising Medical Careers (MMC) is a programme for postgraduate medical training introduced in the United Kingdom in 2005. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the ...
, in particular in the changes it made to the specialist training of doctors and the
Medical Training Application Service
The Medical Training Application Service (MTAS, pronounced ''em-tass'') was an on-line application system set up under the auspices of Modernising Medical Careers in 2007 and used for the selection of Foundation House Officers and Specialty Regis ...
(MTAS). These changes left "29,193 junior doctors from the UK and overseas... chasing 15,600 posts..." and resulted in accusations that the DH had broken the law by refusing to reveal scores to candidates. Ultimately there was a
judicial review
Judicial review is a process under which executive, legislative and administrative actions are subject to review by the judiciary. A court with authority for judicial review may invalidate laws, acts and governmental actions that are incompat ...
and a boycott of the system by senior doctors across the country.
MTAS was eventually scrapped and
Patricia Hewitt
Patricia Hope Hewitt (born 2 December 1948) is an Australian-born British government adviser and former politician who served as Secretary of State for Health from 2005 to 2007. A member of the Labour Party, she previously served as Secretar ...
, the then Secretary of State for Health, resigned following accusations that she had lied to the
House of Commons
The House of Commons is the name for the elected lower house of the bicameral parliaments of the United Kingdom and Canada. In both of these countries, the Commons holds much more legislative power than the nominally upper house of parliament. ...
over the system. Even after the abolition of MTAS, anger among the medical profession continued, with the
British Medical Association
The British Medical Association (BMA) is a registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association's headquar ...
commenting of the DH response that "Not only is this response too late, it does not go far enough".
The
official government inquiry into MMC recommended that the responsibility for medical training be removed from the DH.
Recurrent NHS reorganisation
Successive DH ministerial teams have been criticised for repeated reorganisations of the NHS in England, where primary care commissioning responsibility, in particular, has been allocated to four different sets of organisations in the last ten years: PCGs, small area
Primary Care Trusts
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May ...
(PCTs) (e.g. covering a rural local authority district or part of a city), larger-area PCTs (e.g. covering a whole county), PCT clusters (e.g. quarter of London or South of Tyne and Wear) and the currently unspecified Clinical Commissioning Groups. The tendency to introduce each reorganisation before its predecessor has had time to settle down and generate improved performance has attracted censure amongst healthcare professions in the UK and beyond, including reference to the ironic concept of 'redisorganization'.
Andrew Lansley's promise before the 2010 general election not to impose top-down reorganisation, followed by the instigation from ministerial level of one of the
most fundamental NHS reorganisations yet envisaged, has generated especially widespread opprobrium, although some commentators have also suggested that this is to some extent completing the job started under the Blair administration.
The NHS as of 1 April 2013 is no longer situated within the DH, as NHS England also went 'live' at the same time. Therefore, the DH has a further scrutiny role of NHS services and commissioning.
Information technology
In recent years the Department of Health and the NHS have come under considerable scrutiny for its use of IT. Since being elected to power in 1997 the Labour government had sought to modernise the NHS through the introduction of IT. Although the policy is correct in aim, many claim its execution is lacking.
In September 2008 a new leadership team was established, CIO for Health, Christine Connelly, and director of programme and system delivery Martin Bellamy. Previous CIO Richard Granger was believed to have been the most highly paid civil servant in the UK and was a controversial figure. Connelly left the DH for a position in the Cabinet Office in June 2009 and was replaced by Tim Donohoe and Carol Clarke.
Connelly's role was to "deliver the Department's overall information strategy and integrating leadership across the NHS", according to the DH's website. That strategy, known as the National Programme for IT, is intended to do nothing less than revolutionise NHS information workflow and is costed at about £12.7bn. The success or otherwise of Connelly's reign will be based on her promise to end delays of electronic medical records. She has said that if there is not clear progress by November 2009, a new plan could be hatched.
On the eve of the departure of Fujitsu as an outsourcing partner, Connelly said in April 2009 that she would open up sourcing to competition at "acute" sites in the south of England and offer toolkits by March 2010 to allow more local configuration of systems.
In January 2009, MPs criticised DH for its confidentiality agreement with key supplier CSC and in March the department was admonished by the Information Commissioner for its records management. In May 2011, Prime Minister
David Cameron
David William Donald Cameron (born 9 October 1966) is a British former politician who served as Prime Minister of the United Kingdom from 2010 to 2016 and Leader of the Conservative Party from 2005 to 2016. He previously served as Leader o ...
announced that he was considering scrapping the project.
In 2022
Sajid Javid
Sajid Javid (; born 5 December 1969) is a British politician who served as Secretary of State for Health and Social Care from June 2021 to July 2022, having previously served as Home Secretary from 2018 to 2019 and Chancellor of the Exchequer ...
launched the ''Plan for Digital Health and Social Care'', which includes “regulatory levers” will be used to: “signal that digitisation is a priority, identify the non-negotiable standards of digital capability,
ndexplain how we will monitor and support compliance”. Integrated care systems will be required to put in place a joined-up health and social care record by March 2025 in which all clinical teams will have access to a complete view of a person’s record that they can contribute to. In 2022 86% of trusts had “some form of electronic patient record” but only 45% of social care providers used a digital social care record, and 23% of care home staff cannot access the internet consistently. The
NHS App is to be a “digital front door” for patients, with increasing functionality to be added and remote consultations with GPs are to be encouraged. £25 million is to be provided in 2022/23 to support the rapid digitisation of social care, including adopting Digital Social Care Records.
2010–11 staffing cuts
In response to Government spending reduction targets following the 2008-9
international financial crisis and subsequent
recession
In economics, a recession is a business cycle contraction when there is a general decline in economic activity. Recessions generally occur when there is a widespread drop in spending (an adverse demand shock). This may be triggered by various ...
, DH in common with several other Government Departments resorted to large-scale staffing reductions. In order to minimise redundancy costs, the predominant impact was upon DH staff not employed through a traditional civil service 'headcount' contract, with a resultant emphasised effect upon more recent or innovative work-streams dependent upon seconded or externally hosted staff. This has attracted criticism from several of the professional and patient communities of interest concerned, for instance as regards the impact upon
Improving Access to Psychological Therapies
Improving Access to Psychological Therapies (IAPT), also known as talking therapies is a National Health Service (England) initiative to provide more psychotherapy to the general population. It was developed and introduced by the Labour Party as ...
(IAPT) and the withdrawal of the practical assistance available to the NHS and local authorities via the
national support team
The public health National Support Teams or NSTs constituted a consultancy-style organisational development and change management service provided by the UK Government Department of Health.
History and role
Established in 2006, they provided co ...
s.
Devolution
Most health policy in Scotland, Wales and Northern Ireland is devolved to the department's counterparts:
* the
Scottish Government Health and Wellbeing Directorate
The Health and Social Care Directorates are a group of directorates of the Scottish Government. They are responsible for NHS Scotland, as well as policies on the development and implementation of health and social care.
The Chief Executive of NH ...
* the
Welsh Government
The Welsh Government ( cy, Llywodraeth Cymru) is the Welsh devolution, devolved government of Wales. The government consists of ministers and Minister (government), deputy ministers, and also of a Counsel General for Wales, counsel general. Minist ...
* the
Department of Health
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their ow ...
,
Northern Ireland Executive
The Northern Ireland Executive is the devolved government of Northern Ireland, an administrative branch of the legislature – the Northern Ireland Assembly. It is answerable to the assembly and was initially established according to the ter ...
The
comparability factor (the proportion of spending in this area which is devolved) was 99.5% for all three countries for 2021/22.
A number of health issues are, however, wholly or partly reserved to Westminster:
Scotland
* regulation of the
health profession
The following outline is provided as an overview of and topical guide to health sciences:
Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple aca ...
s
*
xenotransplantation
Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenograft ...
*
embryology
Embryology (from Greek ἔμβρυον, ''embryon'', "the unborn, embryo"; and -λογία, '' -logia'') is the branch of animal biology that studies the prenatal development of gametes (sex cells), fertilization, and development of embryos and ...
,
surrogacy and
human genetics
Human genetics is the study of inheritance as it occurs in human beings. Human genetics encompasses a variety of overlapping fields including: classical genetics, cytogenetics, molecular genetics, biochemical genetics, genomics, population gene ...
* human
fertilisation
Fertilisation or fertilization (see spelling differences), also known as generative fertilisation, syngamy and impregnation, is the fusion of gametes to give rise to a new individual organism or offspring and initiate its development. Proce ...
*
medicines
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and re ...
, medical supplies and
poisons
Poison is a chemical substance that has a detrimental effect to life. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broa ...
Northern Ireland
*
xenotransplantation
Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenograft ...
*
surrogacy
* human
fertilisation
Fertilisation or fertilization (see spelling differences), also known as generative fertilisation, syngamy and impregnation, is the fusion of gametes to give rise to a new individual organism or offspring and initiate its development. Proce ...
and
embryology
Embryology (from Greek ἔμβρυον, ''embryon'', "the unborn, embryo"; and -λογία, '' -logia'') is the branch of animal biology that studies the prenatal development of gametes (sex cells), fertilization, and development of embryos and ...
* human
genetics
Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
In Northern Ireland,
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
law is a criminal justice matter and is devolved.
Wales
* regulation of the
health profession
The following outline is provided as an overview of and topical guide to health sciences:
Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple aca ...
s
*
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
*
xenotransplantation
Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenograft ...
*
embryology
Embryology (from Greek ἔμβρυον, ''embryon'', "the unborn, embryo"; and -λογία, '' -logia'') is the branch of animal biology that studies the prenatal development of gametes (sex cells), fertilization, and development of embryos and ...
,
surrogacy and
human genetics
Human genetics is the study of inheritance as it occurs in human beings. Human genetics encompasses a variety of overlapping fields including: classical genetics, cytogenetics, molecular genetics, biochemical genetics, genomics, population gene ...
*
medicines
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and re ...
, medical supplies and
poisons
Poison is a chemical substance that has a detrimental effect to life. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broa ...
See also
*
Government of the United Kingdom
ga, Rialtas a Shoilse gd, Riaghaltas a Mhòrachd
, image = HM Government logo.svg
, image_size = 220px
, image2 = Royal Coat of Arms of the United Kingdom (HM Government).svg
, image_size2 = 180px
, caption = Royal coat of arms of t ...
*
United Kingdom budget
The Budget of His Majesty's Government is an annual budget set by HM Treasury for the following financial year, with the revenues to be gathered by HM Revenue and Customs and the expenditures of the public sector, in compliance with government p ...
*
Healthcare in the United Kingdom
Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together wi ...
*
Health in the United Kingdom
Health in the United Kingdom refers to the overall health of the population of the United Kingdom. This includes overall trends such as life expectancy and mortality rates, mental health of the population and the suicide rate, smoking rates, a ...
*
National Data Guardian for Health and Care in England
The National Data Guardian for Health and Social Care is an independent, non-regulatory, advice giving body in England sponsored by the Department of Health and Social Care. Dame Fiona Caldicott had held the position on a non-statutory basis since ...
References
External links
*
Catalogue of the Ministry of Health Departmental Whitley Council Staff Side archives held at the
Modern Records Centre, University of Warwick
{{authority control
Health in the United Kingdom
Health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
United Kingdom, Health
1988 establishments in the United Kingdom