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GPs can’t afford to block NHS reform

Fundamental change is required to avert an NHS crisis, says Simon Burns – and GPs' backing is crucial

Today, the NHS helps people live longer and healthier lives than ever before. But increasingly expensive medicines and an ageing population mean it's under more pressure than ever before too.


Ignoring those huge challenges today will mean a crisis tomorrow. We need to change the NHS to make it work better now and in the future, and GPs have a central role to play.

But it's vital that we pursue the right change, in the right way. That is why we paused and set up the NHS Future Forum to listen to everyone who had concerns.

The Future Forum, a group of independent experts, confirmed there was considerable support for the thrust of the principles – giving more power to GPs and nurses, more control to patients and reducing bureaucracy. But it also said some of the ways we were putting those principles into practice could be improved.

We have accepted all of its core recommendations. I believe our proposals are stronger as a result. But why is it so important that health professionals back our reforms?

Doctors and patients told us that under the current system, quality of care depends too much on where you live.

We will take action to stop that.

Putting GPs in control of their budgets will allow them to design health services that suit their community. They know their patients best.

But, to get this absolutely right, they need input from the widest possible range of experts, so clinical commissioning groups will now include nurses, hospital doctors and patients.

Slowing the pace

Some people were also concerned that change was happening too fast. Let me be clear – no GP or clinical consortium will be forced to take on anything before they are ready.

But that doesn't mean that some areas will be left behind. The NHS Commissioning Board will oversee local commissioning for local patients until clinical groups are ready to take over.

In the future, patients will be able to get involved with the design of local services and hold their local NHS to account. But more importantly, just by making simple choices about the care they want and where they want to get it, they will drive improvements.

This inevitably means services will compete on quality. When GP commissioners look at which service they want for local patients, they will make their decision based on quality, not on price.

Some of those services come from independent providers. This is not new. In fact, £1 in every £20 currently spent in the NHS goes to either private or voluntary sector providers – GP practices across the country are already run by private providers.

Using independent providers does not mean selling off the NHS. We will never do anything to put the NHS at risk.

Providers meeting the highest NHS standards will only be paid for the services they provide, so for the first time people will truly be able to demand ‘no decision about me, without me'.

Choosing choice

Last month saw this move closer. We published guidance on expanding choice, meaning all areas should be offering a choice in three services by October.

What does this mean? It means children getting wheelchairs more quickly. It means people with mental health conditions choosing to receive their care somewhere closer to home or older people being able to choose a service that will come to their home – it's about real choices for people over their care, leading to better results.

Funding will also increase, with £12.5bn more for the NHS by 2015. Not cutting, but spending more. Every penny the NHS saves through greater efficiency will also be invested back into front-line care.

Every year we don't modernise, costs escalate. Ignoring these pressures, not adapting or changing, will result in a genuine crisis for the NHS in a matter of years.

Simon Burns is minister of state for health