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Health bill amendments unveiled as Cameron and Miliband clash over GP support

Ministers have revealed details of a series of amendments to the Health and Social Care Bill designed to placate the raft of concerns raised by the House of Lords.

The changes include a clearer directive to both clinical commissioning groups and the health secretary to promote a ‘comprehensive health service', following fears that CCGs could initiate controversial rationing of some services.

Read the full set of amendments here

The Government has also attempted to beef up safeguards against conflicts of interest in CCGs, and inserted clauses that will require the new GP-led bodies to give clearer evidence on how they are tackling health inequalities and promoting education and training.

The amendments came after Labour leader Ed Miliband launched a stinging attack on Prime Minister David Cameron during Prime Minister's Questions yesterday over the bill, and followed the Royal College of Psychiatrists becoming the latest major medical institution to withdraw support for the reforms.  

On CCGs and the secretary of state's duties, the Government said: ‘Our amendments…link the CCG duty to the commissioning board's concurrent duty to promote the comprehensive health service…and ensure the link applies to all NHS services which CCGs commission.'

On health inequalities, amendments have been tabled to require the NHS Commissioning Board and CCGs ‘to include an assessment in their annual reports of what they have done to fulfil their health inequalities duties'.

The Government has also widened the scope for CCGs to examine potential conflicts of interest, by requiring them to consider not just the interests of board members, but of ‘all members of committees or sub-committees of either the group or its governing body.'

And on education, it admitted: ‘We agree that the bill could say more…and have tabled amendments to place a duty on the NHS Commissioning Board and CCGs to have regard to the need to promote education and training.'

The BMA and RCGP have yet to issue formal responses to the amendments.

In an announcement yesterday afternoon, the Royal College of Psychiatrists became the latest organisation to voice fears over the reforms, saying it believed ‘the consequences of the bill will be entirely different from the principles which were originally set out'.

‘[We] do not consider that it will improve the health and care of people with mental illness. Indeed, we have strong concerns that it will have the opposite effect,' the college's statement said.

The amendments followed a stormy day in Parliament yesterday for the Government, with Ed Miliband accusing Mr Cameron of having ‘comprehensively lost the medical profession's trust' over the reforms.

Mr Cameron responded by once again invoking the GPs involved in CCGs as evidence of support.

‘There are tens of thousands of GPs up and down the country who are implementing our reforms because they want decisions made by doctors not bureaucrats,' he said.

But the Prime Minister suffered a further setback yesterday when a GP in his own constituency in Witney, Oxfordshire, criticised the reforms.

The unnamed GP told the New Statesman: ‘I would say very few GPs are happy with [the reform] at all. [It's] not a question of supporting it, it's a question of going along with it.'