By Pulse news desk
09:40 Former Labour health secretary adds his tuppence to the recriminations after the Government’s changes to the health bill, saying they have missed a major chance in a generation to reform the NHS.
In slightly overblown comments, he is quoted in the Guardian this morning saying the health reforms represent the ‘biggest nationalisation since Nye Bevan created the NHS in 1948’ and created ‘the daddy of all quangos’ in the NHS Commissioning Board.
09:00 Dr Hamish Meldrum draws a line underneath the BMA’s opposition to the health bill, with a call for GPs to gather themselves up and ‘move on’. Does this mean the BMA has given up the fight? Read the full story here: Meldrum: Time to move on
Wednesday 15 June
16:00 The plethora of new bodies introduced by the Government to oversee consortia decision-making will increase bureacracy and may become the ‘tail wagging the dog’ of commissioning groups, warn top GPs. Read the full story here: GP commissioning leads warn health bill changes could ‘recreate PCTs’
14:00 Top medical accountant Bob Senior on where premises responsbility will sit…’Premises has worried the hell out of me. I understand DH are planning to move that over to consortia too. This would create a while new conflict of interest. If you want your premises improved you will have to go to your peers.’ He was speaking at the Commissioning Live conference in London.
10.20 Andrew Lansley takes a grilling from pathfinder GPs, who press him particularly hard on the proposals for a mandatory hospital consultant on every consortium board – particularly given that they won’t be able to be consultants working for a local provider. Mr Lansley suggests the consultants could be recently-retired, from tertiary care or based elsewhere in the country.
09.30 This morning we get to hear from the man behind the bill, health secretary Andrew Lansley. He’ll be delivering a keynote speech to the 2011 Commissioning Show in Olympia, west London – in front of an audience of hundreds of GPs.
09:20 Our survey reveals danger of two-tier commissioning system in England: Majority of GPs do not want 2013 start for commissioning
Tuesday 14 June
14.48 The BMA has responded to the Government’s proposals earlier today, with the following statement from its chair, Dr Hamish Meldrum.
‘We are pleased that the government has accepted the Future Forum’s core recommendations, and that there will be significant revisions to the Health and Social Care Bill. We will need to look carefully at the details of the changes, but it seems clear that what we are likely to see is a very different Bill, and one which puts the reforms on a better track. There is much in the government’s response that addresses the BMA’s concerns, and many of the principles outlined reflect changes we have called for. The success of the reforms will very much depend on how the various elements link together and work on a practical level, and on how much they engage clinicians and patients locally.’
‘We welcome the shift in the role of Monitor away from promoting competition. However, while we have always supported the principle of greater choice for patients, it has to be workable. There will need to be robust safeguards to ensure that vital services are not destabilised by unnecessary competition.’
‘More detail is needed about the way clinical commissioning groups will operate in practice. While greater accountability and transparency around their decision-making processes are welcome, they should not be encumbered by bureaucracy.’
‘It is reassuring that the government recognises there are still a number of issues to work through. It is particularly important that dialogue continues on education and training and the development of incentives for commissioners. We look forward to continuing our discussions with the government to help ensure that NHS reform is best for patients and workable for staff. Hanging over all this, however, is the fact that the NHS is facing unprecedented financial pressures. The focus on structural reform must not distract us from the task of minimising the impact of funding cuts on care.’
12:40 Prime minister David Cameron claims: ‘We have listened, we have learned, and we are improving our plans for the NHS’. Read the full text of David Cameron’s speech here.
12.30 Key lines from the Government’s response include the rebranding of GP consortia to ‘clinical commissioning groups’, mandatory inclusion of a nurse and a hospital consultant on the board of each group and revisions to the controversial quality premium. Read the Government’s full response to the NHS Future Forum here.
12.20 The Department of Health has now published its full response to the NHS Future Forum report – and there’s some fundamental changes. Prime Minister David Cameron is outlining them at the moment… more follows.
10:27 NHS Alliance has welcomed the NHS Future Forum report, but warned any further delays will jeopardise the success of the reforms. Read the full NHS Alliance response here
09.35 Another hugely busy day of health bill coverage to come, as the Government sets out its response to the Future Forum report. Prime minister David Cameron is due to lay out his response in a speech at a London hospital at 12pm, and then Andrew Lansley will address Parliament mid-afternoon – the latest from Downing Street about the timing of this is that it’s due for 3.30pm.
Monday 13 June
18.06 Reaction to the NHS Future Forum report continues to pour in, and you can read a full roundup here.
On Twitter, the Labour blogger Hopi Sen has a nice line: ‘Well done Cameron, Clegg & Lansley for achieving first ever top down reorganisation of a top down reorganisation of the NHS…‘
16.43 RCGP chair Dr Clare Gerada’s response is a little more hesitant than Dr Hamish Meldrum’s.
We are encouraged by the Forum’s recommendations for the future role of Monitor in relation to competition, and the report’s insistence that private providers should not be allowed to ‘cherry pick’ patients,’ she says.
‘But we still have a number of outstanding concerns about the potential risks and unexpected consequences of the proposals. We need the Government to reassure us that GPs will be given the freedom and autonomy to lead the decision-making and design of future integrated health systems drawing on the support of other health, social care and third sector services.
15.51 BMA chair Dr Hamish Meldrum has praised the ‘constructive approach’ of the Government’s listening exercise, and has issued a very upbeat response to the Future Forum report.
‘The Future Forum’s recommendations address many of the BMA’s key concerns, to a greater or lesser extent. We are hopeful that our ‘missing’ concerns, such as the excessive power of the NHS Commissioning Board over consortia and the so called ‘quality premium’ will be addressed as more detail emerges. While we welcome the acknowledgement that the education and training reforms need much more thinking through, there needs to be immediate action to prevent the imminent implosion of deaneries.
“Obviously, the critical factor is now how the government responds, as well as ensuring that the detail of the changes matches up to expectations. But if the Government does accept the recommendations we have heard today we will be seeing, at the least, a dramatically different Health and Social Care Bill and one that would get us onto a much better track. There will then still be plenty more to do to ensure that the amended reforms do support the NHS and its staff in continuing to improve care for patients and tackle the major financial challenges ahead.’
15.41 The press conference has now wrapped up – Professor Steve Field heads off to complete an exhausting round of media interviews.
15.23 Now Professor Field’s asked if he felt eight weeks was long enough to compile the report.
‘We gave up our day jobs for eight weeks – and we only had eight weeks,’ he says. ‘Some areas need more time – eg education and training, we need to take care of the training so the deaneries don’t fall about. More work’s needed on networks, and the assurance processes of consortia – and public health.’
15.20 Professor Steve Field is asked at the press conference if he thinks there’s anything in his report which the Prime Minister and health secretary won’t accept.
‘The papers are the distillation of eight weeks’ work,’ he replies.
‘Even in the last two days we picked up new issues. We haven’t discussed it in detail yet; they quizzed us this morning, but we look forward to their response tomorrow.’
15.15 Reaction to the bill is coming in from all quarters. Dr Michelle Drage, chief executive of Londonwide LMCs, is unimpressed. ‘Copouts galore – raises more questions that answers,’ she tweets.
14.50 Professor Steve Field on one of the more controversial parts of the reforms: ‘Monitor’s role in relation to competition should be significantly diluted in the bill.’
14.40 Professor Steve Field says his listening exercise has gathered the views of 6,500 people and received more than 25,000 emails.
14.31 The NHS Future Forum report is officially published. Download the full report here – and our online reporter Ellie Broughton is reporting from the press conference at the moment. Follow the latest developments live here.
13.55 The Telegraph reports that David Cameron has told a meeting of backbench Conservative MPs that the forthcoming changes to the health bill were ‘nothing to do with the Lib Dems’.
13.11 A quick word about the schedule for today. Professor Steve Field’s NHS Future Forum report will be officially unveiled at a press conference at the King’s Fund later today.
The press conference officially gets underway at 2.30pm. Follow the latest developments live here.
13.00 Welcome to Pulse’s live coverage of the Government’s relaunch of the NHS reforms. The next few days are likely to play a crucial role in determining the future of the health bill and GP commissioning – we’ll be updating this blog with the latest news and analysis as it happens.
NHS reforms liveblog