A campaign group is challenging the legality of the government’s scheme to restructure the NHS in the first High Court hearing on the controversial issue today.

999 Call for the NHS, represented by law firm Leigh Day, are fighting plans by NHS England to introduce Accountable Care Organisations (ACOs) which they believe could lead to patients care being compromised by financial considerations.

The introduction of ACOs will mean that local hospital trusts and clinical commissioning groups, which currently oversee local GP services, will no longer receive an annual budget of their own but will instead become part of a wider ACO. Each ACO will then receive an annual budget to provide all publicly funded healthcare across a geographic area.

Campaigners are concerned the proposed changes will mean medical professionals will be forced to make decisions around the care a patient receives on the basis of treatment costs rather than medical need.

The judicial review, which is being heard at the High Court in Leeds, has been brought by the campaign group 999 Call for the NHS. The group says the new contracts for ACOs are unlawful under the Health and Social Care Act 2012 and could threaten patient safety by forcing care providers to potentially restrict patients’ access to treatment.

In a broader sense the campaign group also believe the core principle of the NHS of providing comprehensive care to all is being threatened by the introduction of ACOs.

Solicitor Rowan Smith, from Leigh Day, who is representing 999 Call for the NHS, said:

"We all know how controversial the Health & Social Care Act 2012 was at the time. That’s why the then government included the payment by results system as a safeguard against a feared race to the bottom.

"NHS England is now attempting to circumvent that protection for patients through the back door and outside of the existing statutory framework.?? If NHS England does not have the legal power to introduce these new ACO contracts, then it will have to go back to the drawing board, which can ultimately only be a good thing for patients."

Joanne Land, from 999 Call for the NHS, said:

"As well as being undemocratic, NHS England’s proposed changes to how NHS services are priced and paid for would undermine the NHS as a comprehensive health service for all who have a clinical need for it.

"They are about enabling moves to a cut-price, bargain basement NHS that uses the same business model as the USA’s limited state-funded health insurance system that provides a restricted range of healthcare for people who are too poor or too old to pay for private health insurance."