Govt won’t make any ‘fundamental’ changes to NHS reforms
The government’s NHS listening exercise will not result in any “fundamental” changes, the head of a leading health charity has said.
Writing for politics.co.uk Neil Churchill, chief executive of Asthma UK, said he expected any changes to be in “the details”.
Comment: Changes to NHS reforms will be in the details
“The changes won’t be fundamental ones, as the review’s terms of reference make clear,” he wrote.
“The NHS commissioning board and GP consortia are coming, whatever people argue today.
“Competition too will play a major role in the new health service, although the debate will continue over whether this is an evolution from Tony Blair’s reforms or a break with them.”
But Mr Churchill said he expects changes to be made to the language of the bill that could result in “less of a gap between the principles behind change and the reality of their implementation”.
He said he expects GPs will not be the sole commissioners, with clinicians likely to be included on the consortia’s boards.
Mr Churchill’s comments come more than two weeks after the government launched a ‘listening exercise’, following sustained criticism of the health secretary Andrew Lansley’s proposed reforms to the NHS from leading health professionals and the public.
The government promised to “listen, pause and reflect”, while making “substantive” changes to the health bill.
Mr Churchill was one of the charity chiefs invited to Downing Street a little over two weeks ago at the start of the health bill’s ‘pause’ – alongside representatives from WhizzKidz, Mencap and Marie Curie.
David Cameron urged the gathered charities to help sell the reforms to the public.
“Your organisations, which are hugely trusted and understood by the public and by users of your organisations, can help us make the argument that change, that choice, that diversity is not about privatisation, it’s actually about improving healthcare,” the prime minister said.
During the meeting, Mr Churchill noted the slightly different rhetoric used by the prime minister and his deputy. Mr Cameron spoke of “tweaks” to the bill, but Nick Clegg described “tweaks or changes” – highlighting their different perspectives on the reforms.
Mr Clegg is under greater pressure to change the health bill as Liberal Democrats rejecting the reforms at the party’s conference.
Mr Churchill agreed that the bill’s emphasis on “plurality of provision” was in the interest of patients, alongside more emphasis on patient choice and control.
And he said there was always room for improvement in the NHS, saying the service still had “unacceptable variations in quality”.
“Personally I count myself a late convert to GP commissioning, and can see that in the right hands it could be a powerful means to enhance the ‘front end’ of healthcare – primary care,” he wrote.
But Mr Churchill raised concerns about the scale and the timing of the reforms, at a time when the NHS is being asked to make £20 billion of efficiency savings by 2014/15.
He pointed to fears over integration, arguing competition could create fragmented services, and said there needed to be “incentives to collaborate” equally strong as those to compete.
The Asthma UK chief also said there was a lack of detail in the bill that made it unclear what role patients will have in GP consortia or NHS commissioning boards.
And he pointed to an issue raised by Ed Miliband at prime minister’s questions: the potential for GPs and hospitals to charge for services.
Over the next two months, health charities will offer their own solutions and ideas to the government, but Mr Churchill said he did not expect the “heat” to subside in the public debate over the future of the NHS.
