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Reaction: Health Bill

Read all the reaction to the publication of the Government's proposed health legislation.

'Depending on how the reforms are implemented, we must guard against fragmentation and unnecessary duplication within a health service that is run by a wide array of competing public, private and voluntary sector providers, that delivers less choice and fewer services, reduces integration between primary and secondary care and increases bureaucratic costs.' Dr Clare Gerada, chair of the RCGP

'There is a danger that, in the new system, services will go to the cheapest provider at the expense of quality. There is also a danger that, if a multiplicity of providers are delivering different aspects of care, that care may be fragmented and patients may fall between gaps in services.' Dr Laurence Mynors-Wallis, registrar of the Royal College of Psychiatrists

'Many GPs have been fighting for these reforms for a number of years and after a few false starts, it is good to see the Government is listening and taking the appropriate measures. It is courageous and right. The NHS Alliance welcomes the principles behind the reforms which will put GPs and patients in the driving seat when it comes to raising the quality and efficiencies of services.' Dr Michael Dixon, chair of the NHS Alliance

‘The Government's reforms propose substantial changes and will require significant management expertise to implement smoothly. As our latest report into the American experience of GP commissioning concludes, substantial investment in leadership, management and IT will be vital. There are clear risks of introducing GP commissioning in England when the Government has placed such a strong emphasis on reducing management costs.' Dr Jennifer Dixon, director of the Nuffield Trust

‘The real choice is not between stability and change, but between reforms that are well executed and deliver results for patients, and reforms that are poorly planned and risk undermining the NHS. We hope this will be uppermost in the minds of MPs and peers as they debate the Bill over the coming weeks.' Professor Chris Ham, CEO of the King's Fund

'The scale and pace of change – and the challenge of unprecedented efficiency savings - should not be underestimated. Neither should the risks if we get this wrong. We are also anxious to ensure that the system builds in effective safeguards to protect against service fragmentation. The fragmentation of services would have detrimental impacts on the very areas the reforms seek to improve: the quality of services, education and training, patient choice, efficiency and equity." Sir Richard Thompson, president of the Royal College of Physicians

'We support the objectives behind this legislation but there are huge risks and major uncertainties associated with it. A key issue in the bill is accountability. With central government loosening day-to-day control, we need to be sure who is going to get a grip when things go wrong. With proper checks and balances in place, a new NHS system will be able to manage itself while making tough decisions in a fair, ordered way. Without proper accountability, the risk is that positive dynamic change will become chaos and instability.' Nigel Edwards, NHS Confederation acting chief executive

'The NHS is about more than doctors, and GP commissioning has to be about more than GPs. The Health Secretary acknowledges that pharmacists have an important and expanding role in supporting better health, but we now need to see his words backed by action. Pharmacists see more people, more often, even than GPs do.' Rob Darracott, chief executive Pharmacy Voice

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