Changes to plan to give GPs more control of NHS budget

MAJOR LEGISLATION to give GPs control over most of the National Health Service’s budget in England will be changed to give a …

MAJOR LEGISLATION to give GPs control over most of the National Health Service’s budget in England will be changed to give a greater role for hospital staff and councillors, according to British prime minister David Cameron, although he insisted that reforms were needed to ensure that it was able to cope with a rapidly ageing population.

Under the existing plans, GPs would be given control of an £80 billion budget and the freedom to purchase medical treatments for their patients. This has provoked fears that the plans will weaken NHS operations, remove any form of democratic accountability and lead to sharply different standards in different parts of England.

Now, however, Mr Cameron has ordered health secretary Andrew Lansley to put his plans on hold for several months of consultations with key players, fearful that the reforms – which were not included in the Conservatives’ election manifesto or in the programme for government with the Liberal Democrats, could damage the Conservatives.

Acknowledging that the “pause” in the legislation’s passage through Westminster was unusual, Mr Cameron, who toured a hospital yesterday with Mr Lansley and deputy prime minister Nick Clegg, said the consultation was not just a cosmetic exercise to buy political breathing space, but would lead to “substantive” changes.

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Instead of just including GPs, the commissioning units to be set up to purchase services would include a hospital doctor, a nurse, a public health expert, a social care representative and an elected councillor, although majority control would still be held by GPs, Downing Street sources indicated last night.

Addressing staff at a Surrey hospital, Mr Cameron said: “Let me be clear – this is a genuine chance to make a difference. Where there are good suggestions to improve the legislation, to improve the changes, those changes will be made, but let me be equally clear – the status quo is not an option.”

The number of 85-year-olds and over will double in the next 20 years, while medical advances are adding £600 million a year to the NHS’s cost. “If we want to keep a health service that is truly free at the point of use – not just this year, not just next year, but in the decades to come – we have got to make the NHS more effective. Pumping in a bit more money and sticking with the status quo is not going to work.”

Rejecting charges that a US- style health system was approaching, Mr Clegg said private hospitals would not be able to cherry-pick the most profitable operations, leaving the NHS to cope with the rest, nor would they interfere with the 60-year-old tradition of healthcare free at the point of delivery.

“We say yes to a family doctor choosing a nurses co-op to visit you in your home. We say no to a US-style healthcare system where they check your credit card before they check your pulse.”

Mr Clegg’s own party rebelled at a recent conference against the Lansley plans, demanding fundamental changes.