The government has responded formally to the Future Forum’s recommendations, proposing “significant” amendments to the Health Bill.
In its response to its listening exercise on the Bill, the government said the legislation will need to be updated around consortia governance arrangements and competition in the NHS.
GP consortia will now be called clinical commissioning groups and their governing bodies will have at least one nurse and one specialist doctor on them. Commissioners will be supported by advisory clinical networks and senates.
The government was responsive on public accountability, outlining a greater role for the public across the reform agenda. It committed to creating a stronger role for health and wellbeing boards in local councils, with the right to refer back local commissioning plans.
On political accountability, the government said that the original ministerial duty of promoting a comprehensive health service will remain.
Controversially, the coalition re-stated its commitment to competition but said it would guard against “the dangers of competition being an end in itself”.
“We are committed to giving patients greater choice and creating a level playing field, in which the best providers flourish, whether from the public, voluntary or private sector,” the government said. “We will make sure that what matters is the quality of care provided, not who owns the organisation providing it.”
To this end, the regulator Monitor’s core duty will be to protect and promote the interests of patients - not just to promote competition; there will be new safeguards against price competition, cherry picking and privatisation; and, there will be stronger duties on commissioners to promote integrated care.
On doctors’ training, deaneries will remain while Health Education England is established and sets a course towards “provider-led networks in a phased way”.
The Bill will return to a Commons public bill committee for further scrutiny before progressing to its final Commons stages. It will then be scrutinised in the Lords.
The BMA welcomed the commitments but raised concerns over powers of the Commissioning Board over clinical commissioning groups and how the ‘any qualified provider’ policy will work.
Dr Hamish Meldrum, chair of BMA council, said: “We look forward to continuing our discussions with the government to help ensure that NHS reform is best for patients and workable for staff.”
Read the government’s response.
Tags: Health policy
Some regard the Govt’s ‘change of heart’ as a (derogatory) ‘U-turn’; I suggest it is better that they have ‘listened and learned’ than that they should have ploughed ahead with blind beligerance!
There can be little doubt that they have accepted many of the recommendations of ‘The Forum’ and the various sections of the profession.
The main problem of the NHS, however, has not been addressed - demand exceeds supply; and that means RATIONING - a word that politicians refuse to use (but ultimately the public MUST be told). The ‘Commissioning Bodies’ (whoever they are and whatever they are called) will have to ‘restrict’ the pruchasing of some treatments and maybe ‘refuse’ to purchase others - so THEY will be blamed. The accusation of ‘postcode lottery’ will be made - yet the needs of one district or area ARE DIFFERENT from another (big cities, county towns, university towns and holiday resorts, sparsely poulated rural areas have different problems). It is the duty of the Govt. to determine what ‘core services’ MUST be available in ALL areas - and, surely ‘A&E’ must be the first priority when money is short?