Currently Section 1 NHS Act 2006 provides that the Secretary of State (SoS) must continue the promotion in England of a comprehensive health service designed to secure improvement in (a) in the physical and mental health of the people of England, and (b) in the prevention, diagnosis and treatment of illness. In addition, the SoS must, for that purpose, provide or secure the provision of services in accordance with this Act.

The first part of this remains but the second changes. As the explanatory notes makes clear, the Bill draws a distinction between the SoS public health functions and his role in relation to the securing of services for the purpose of the NHS.

The SoS will have new duties in respect of public health and securing the provision of services from the NHS Commissioning Board, consortia and local authorities. New duties cover a duty as to improvement in quality of services, a duty as to reducing inequalities and a duty as to promoting autonomy.

Looking at quality of services the relevant outcomes will be effectiveness, safety and quality. The SoS has to have regard to NICE quality standards.  

This strikes us as an area ripe for judicial review!

The autonomy duty will prove interesting. The explanatory notes indicate that when considering whether to place requirements on the NHS the SoS has to make a judgment as to whether these are in the interests of the health service. He must not impose unnecessary burdens.