A leaked document suggests that Prime Minister Boris Johnson is planning major reforms in a proposed extensive shake up of NHS England. The changes could see more power placed in the hands of politicians, and also reduce the role of the private sector in the health service. The reforms, scheduled for introduction next year, could see large parts of legislation brought in under the Conservative and Liberal Democrat coalition in 2012 undone. The draft of the White Paper states that “NHS England’s proposals form the foundation of this Bill”. The draft explains: “Their recommendations for legislation were designed around three important principles that still stand today: any legislation should solve practical problems; avoid disruptive top down reorganisation; and have broad consensus within the system.” The plans say that the “majority of our proposals either directly implement or build upon NHS England’s recommendations”. The changes The leaked plans were first obtained by specialist health news website Health Policy Insight, which said that the draft White Paper “unambiguously puts the Secretary of State for Health back in charge, in a massive political land-grab”. Health Policy Insight states: “It undoes 2012’s Health and Social Care Act “Equity and Excellence: Liberating the NHS” (for which all Conservative MPs then in Parliament unanimously voted).” The publication adds that the plan also “abolishes competition and competitive tenders in the NHS” and that it “effectively neuters NHS Foundation Trusts, removing their independence from direct control by the Secretary of State for Health, with the formal abolition of Monitor (known now as NHS Improvement) and the Trust Development Authority”. The Government could acquire the power to block the closure of hospitals, and overrule bosses under the new plans, taking more control over the healthcare of millions of patients. “It also proposes a new Obesity Strategy, which will be to contemplate banning adverts for unhealthy food online and before 9pm on television,” Health Policy Insight explains. Additionally, the Health Secretary is likely to get powers to put fluoride in water, and to intervene in the quality of hospital food. Currently, only councils can add fluoride to water. ‘A roll-back of NHS privatisation would be greatly welcomed’ Gail Cartmail, assistant general secretary of the Unite Union, said: “If the leaked policy paper heralds a roll-back of NHS privatisation, this is to be greatly welcomed, but we would need to go through any proposals with a fine-toothed comb once they are officially unveiled. “The 2012 Health and Social Care Act is recognised as a disaster, fragmenting services and giving too much sway to the profit hungry private sector.” The British Dental Association also said that “movement on water fluoridation is real progress” as “unacceptable oral health inequalities are set to widen as a result of this pandemic”. Reforms could be ‘very positive’ Former Health Secretary Jeremy Hunt said that the proposed changes in the leaked plans could be “very positive”. Speaking to BBC Breakfast, he said: “Last year was the first year in history where, across the world, there were more over-65s than under-fives, so we are all having to deal with this big change in our health provision of the growth in older people and what the means is you need a lot more joined up care. “The structures need to be improved to make that possible and I think that’s what these reforms are intended to do, so I think they could be very positive.” ‘Need for new legislation’ A Department of Health and Social Care spokesperson said: “We do not comment on leaks. “The NHS set out the need for new legislation to support the changing health and care sector in the NHS Long Term Plan, and last summer the Health and Social Care Secretary outlined how we must apply the lessons of this pandemic as we continue to deliver this plan. “From tackling bureaucracy to driving forward the integration of health and care services, we are rightly considering where changes need to be made to help us build back better. “Full details will be set out in due course.”