Cameron unveils NHS bill overhaul to allay criticisms

David Cameron has announced an overhaul of the NHS reforms designed to address criticisms that the government’s original plans would fragment care, to the detriment of vulnerable groups.

In a speech yesterday, he unveiled several changes to the Health and Social Care Bill – whose parliamentary passage was halted in April to address criticisms. These include:-

• That a broader range of clinicians will be involved in commissioning healthcare, with hospital doctors and nurses likely to sit on GP consortia boards.
• That the 2013 deadline for consortia being set up would be relaxed to allow local areas to go at their own pace.
• That the emphasis on competition on the bill would be tempered. Health economic regulator Monitor would have a new duty to promote integrated care within health, and between health and social care.

Provisions in the bill for Monitor to have a duty to promote competition sparked fears from health and social care leaders that the reforms would fragment care to the detriment of groups including people with mental health problems.

“This [duty] could be misinterpreted and we don’t want any doubt in anyone’s mind,” said Cameron. “Monitor’s main duty is to protect and promote the interests of people who use health care services and it will use competition as a means to that end. Not simply to promote it or prevent it, but to secure the services patients need.”

On Monitor’s new duty to promote integration, he said: “Integration is really important for our vision of the NHS. If you’ve hurt your back, we want your GP and physio to talk to each other to find the best course of rehab. And if you’ve got a longer term condition and need social care, we want local services to be actively involved in supporting you to stay as well as possible.”

Cameron’s speech comes ahead of the report next week of the NHS Future Forum, the panel of experts set up to examine criticisms of the bill. The government is likely to amend the bill through a second committee stage in the House of Commons, in which MPs will scrutinise the legislation in detail though it is not clear whether this will happen before or after Parliament’s summer recess.

Cameron’s speech suggests that those elements of the bill that are most pertinent to social care will remain untouched. These include the abolition of the General Social Care Council and transfer of its social work regulation functions to the Health Professions Council, and the establishment of health and well-being boards to integrate health and social care commissioning within local authorities.

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