The Prime Minister has tried to allay concerns over the NHS reforms by abandoning key elements of the Health Bill.
In a speech to medical staff at UCL’s Clinical Neurological Centre, David Cameron confirmed that hospital doctors and nurses will be involved in clinical commissioning.
New clinical senates will be introduced to allow groups of doctors and allied healthcare professionals to “take an overview of the integration of care” across a wide area.
Cameron said: “Our changes will now secure clinically led commissioning, not just GP-led commissioning.”
The Prime Minister also said the main duty of the regulator Monitor will be to promote the interests of patients rather than competition, as previously intended.
Cameron said: “Now, as our legislation stands, Monitor, the health regulator, has a duty to promote competition. This could be misinterpreted and we don’t want any doubt in anyone’s mind.
“Monitor’s main duty is to protect and promote the interests of people who use healthcare services and it will use competition as a means to that end. Not simply tasked to promote it or prevent it, but to secure the service patients need. It will be tasked with creating a genuine level playing field, so the best providers flourish and patients get a real choice.”
The PM stressed, however, that competition was an important way to improve services.
The current 2013 deadline for implementing GP consortia will also be softened. He said: “We will make sure local commissioning only goes ahead when groups of GPs are good and ready, and we will give them the help they need to get there.”
Commenting on the speech, Sir Richard Thompson, president of the Royal College of Physicians, said: “Quality, collaboration and integration must be at the heart of the health service and these principles - not competition - should be the focus of health service regulators.
“The government must take this opportunity to amend the Bill so that patient safety and integrated care are at the heart of the reforms. This can only be achieved with a commitment to include hospital doctors on commissioning boards, and robust arrangements for involving specialists at a national level.”
Dr Hamish Meldrum, chair of BMA council, added: “The Prime Minister’s speech suggests he is committed to integrated NHS services, and the involvement of a wider range of staff in their design. However, he also spoke in glowing terms about the benefits of competition, and we would point to the many damaging effects its application in the NHS has had so far. It is positive that he recognises the need for a level playing field, with private providers contributing to the costs of training and unable to cherry-pick the most profitable services.
“While we obviously await the details of the Future Forum report, and the amendments to the Bill, today’s speech is an indication of a significant step in the right direction.”
Cameron’s concessions are aimed at pacifying the opposition from the medical profession and the Lib Dems. Clegg has been in negotiations with Cameron ahead of a planned joint response after Dr Steve Field, the chairman of the Future Forum, publishes his report next week.
Tags: Health policy
