Labour will flesh out how it would dismantle Andrew Lansley’s structural NHS reforms to bring more health provision back in-house, in a wide-ranging consultation on NHS restructuring under a future Labour government.



The shadow health secretary, Jon Ashworth, said Labour had now rejected the possibility of working within the existing structures, calling them unfit for purpose, and said the party would consult in the coming months over how it could re-establish a universally public NHS.

The party is committing for the first time to a wholesale restructure of the health service. Overhauling NHS structures have traditionally been politically risky. The former Conservative health secretary Lansley generated controversy when he introduced sweeping reforms in his 2012 Health and Social Care Act.

The reforms saw primary care trusts disbanded and new clinical commissioning groups buying and providing local healthcare services, with NHS contracts opened to the voluntary and private sectors.

Ashworth said Labour would consult on how to undo those reforms. “In the past Labour has said it would work within existing structures,” Ashworth said.

“But these structures are not fit for purpose, over the coming months I want to consult on how we move to an NHS based on partnership and planning where privatisation is banished and we restore a universal public NHS.

“It’s my intention that the next Labour government should bring forward legislation to reinstate the NHS, so that the fragmented structure and Health and Social Care Act will be swept away under the next Labour government.”



Ashworth said the arguments about the future of the NHS, as it approached its 70th birthday, should not only focus on more investment, but on structural failures.



“The truth is the Health and Social Care Act combined with Thatcher’s internal market have led to billions wasted, greater privatisation and fragmentation,” he said.



“And yet the delivery of healthcare in the future where whole person care is the expectation depends on greater collaboration and integration at a local level of social care, primary and community care, mental health services in partnership with the acute sector.”

The Nuffield Trust said Labour should tread cautiously in embarking upon a radical restructure. The health thinktank’s senior fellow Helen Buckingham said: “Nobody would say that the current NHS structure is ideal, but reorganising the health service from Whitehall brings its own set of risks, as we have seen all too often.

“It is easy to underestimate the disruption caused by changes which often take years, and to overestimate the actual difference that they make to staff and patients at the front line. Labour must carefully consider the cost and the benefits of any further reshuffling of health service structures, and proceed with caution.”

The outsourcing of a number of NHS services has come under scrutiny in recent months. Last month, a National Audit Office report found that the outsourcing of primary care support services to Capita had put patients at risk and that Capita was incentivised through the contract to close existing services to minimise its losses. The NAO said the arrangement had led to widespread failure of service delivery.

May is expected to announce an increase for the NHS budget for the next few years to coincide with the health service’s 70th birthday in July, and is under pressure from some cabinet ministers including the health secretary, Jeremy Hunt, to commit to around 4%-a-year increases for the rest of the parliament.

The chancellor, Philip Hammond, has argued for only a modest increase, given the state of public finances, and has argued in favour of capping the annual increase at 2.5%.