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NHS financial crisis forces reforms on to back burner

The Department of Health is being forced to backtrack on flagship primary care reforms outlined only weeks ago as a result of the growing financial crisis engulfing the NHS, write Rob Finch and Ian Cameron.

A series of policies revealed in the Our Health, Our Care, Our Say White Paper are to be deferred as a result of the £800 million-and-growing deficit.

Ministers and officials lined up last week to dampen expectations about reforms such as practice-based commissioning, allowing patients to register with a GP near their work and expanding the Expert Patients Programme.

Health Secretary Patricia Hewitt told a meeting of 100 people who had been involved in the public consultation on the White Paper that 'financial difficulties mean some things will have to progress a little slower'.

Lord Warner, health minister, told Pulse at the same meeting he was 'relaxed' about how fast practice-based commissioning was implemented.

At another conference, Gary Belfield, Department of Health head of primary care, made the startling admission that: 'Not everything in the White Paper is completely thought through, fully-analysed policy.'

He told the Laing & Buisson conference: 'There are things that are ideas which we will work through.'

The furious backpedalling came as Sir Nigel Crisp announced he was retiring from his role as NHS chief executive at age 54, conceding he was partly responsible for the huge deficit racked up by the NHS.

On practice-based commissioning, Lord Warner predicted the speed at which GPs signed up would be unaffected by the deficits, but there could be delays in practices taking control of budgets.

He said: 'As long as the soldiers are marching in the same direction, it doesn't matter how long it takes to get there.'

Professor Chris Ham, former director of strategy at the department, said NICE recommendations were another area facing delays.

He said: 'The overriding priority now and in the next year is to get back into financial balance'.

Dr Peter Holden, GPC negotiator, said the lack of cash meant GPs and PCTs had 'no steerage way to innovate'.

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