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PM steps up defence of NHS reforms

By Edward Davie

The Prime Minister has reaffirmed his commitment to GP commissioning as a key reform which will protect the NHS from future challenges and improve patient care.

Speaking to health professionals at Ealing hospital in west London today, David Cameron tried to seize the initiative and move on after another weekend of difficult headlines for the NHS reforms.

Mr Cameron said the current system of PCT commissioning had led to a 'frustrating' lack of interaction within the NHS and to an 'inflexibility' which frustrates both patients and doctors.

'I was sat in a surgery in Birmingham last week, listening to the doctor explain that he has world-class physiotherapists in the same building, but he can't refer his patients to them because the current system stopped it,' he said.

The answer, he insisted, was to give GPs control. The NHS 'must promote prevention and a healthier nation, which must mean giving GPs, who are our first contact with the system and have a good understanding of their area's health needs, a wider role,' he said.

And he confirmed that hospital doctors and nurses will also more closely involved in commissioning. He said: 'It is clear [from the listening exercise] for example, that when people working in our hospitals hear the term "GP commissioning", they worry it's only GPs that are going to be involved in making decisions.'

'Now that's not the case, but I agree we need hospital doctors and nurses to be much more closely engaged in commissioning.'

Last week, Pulse reported that former RCGP chair Professor Steve Field, appointed by Cameron to chair the 'listening exercise' on the Government's health reforms, is to push for major changes to the role of Monitor in promoting competition. The NHS Alliance also warned the Government GP consortia leads felt 'betrayed' by the Government's delay in the reforms.

And on Sunday the Observer reported that the senior Number 10 adviser Mark Britnell had told a conference that the NHS could be improved by charging patients and could be transformed into a 'state insurance provider, not a state deliverer' of care.

According to the newspaper, Mr Britnell, the head of global health at KPMG who has been appointed to a Number 10 'kitchen cabinet' advising Cameron on reforming the NHS, told executives from the private sector that future reforms would show 'no mercy' to the NHS and offer a 'big opportunity' to the for-profit sector.

Responding to the speech, BMA chair Dr Hamish Meldrum said while they agree the NHS needs to change, the current wording of the health bill needs to be 'radically amended'.

'There needs to be greater integration, greater efficiency, and more emphasis on prevention. However, the health bill as it is currently written would make these improvements far harder to achieve, leading to a more fragmented health service, with many hospitals at risk of closure.'

'Whilst we welcome his commitment to listening to staff and to taking them with him, most doctors will not feel able to support this bill unless it is radically amended.'

Story updated at 13:55

David Cameron