Mike Hancock News
Update on NHS Modernisation
NHS modernisation
The Government's response to the independent NHS Future Forum has been published today, accepting their core recommendations. With the changes we will make in response to the Future Forum, our plans mean that:
- First, the NHS we know and love will be safe and secured not just for our generation, but for our children too.
- Second, our plans mean patients will have much greater choice - they will be in the driving seat.
- Third, our plans will mean patients are going to have access to the best healthcare, because as well as giving patients more choice, we're giving patients more information.
- Fourth, our plans will mean a more seamless journey through the NHS - they will break down barriers and get doctors and nurses from different parts of the NHS talking to each other to get the best for patients
Among the key changes we are making in response to the independent NHS Future Forum are the following:
- Reaffirming that Ministers are accountable for the NHS overall, by making clear it is the duty of the Secretary of State to secure an NHS
- Involving a wider range of people in clinical commissioning, including specialists, nurses and members of the public - in 'clinical commissioning groups' - and through advisory clinical senates and networks
- Delivering stronger accountability, by making clinical commissioning groups and NHS Foundation Trusts meet in public and strengthening the influence of Health and Wellbeing Boards over clinical commissioning groups
- Putting in place safeguards on competition, making clear that Monitor must promote the interests of patients and members of the public - not promoting competition as an end in itself, but to support choice and to improve the quality of services - and ensuring that the private sector cannot be favoured over the NHS
- Supporting integrated care, through stronger duties to promote integrated care and by making it clear that clinical commissioning groups will not normally cross the boundaries of local authorities
- Involving patients, with new duties on clinical commissioning groups to involve patients in commissioning decisions, in order to better reflect our core aim of 'no decision about me without me'
- Phasing the transition, by ensuring that clinical commissioning groups take on responsibility for commissioning health services when they are good and ready, and carefully planning future changes to education and training
The changes we are making will be recommitted to a Public Bill Committee, so that Parliament has a full opportunity to scrutinise the changes. A high-level Q&A is appended to this letter.
Q&A
- 1. Which side of the Coalition has won?
The only people who will win are the patients and hardworking NHS staff.
- 2. You're removing the duty of the Secretary of State to provide the NHS aren't you?
The Secretary of State and the Government will always be accountable for securing the provision of the NHS and we will amend the Bill to put this beyond doubt. The wording of section 1(1) of the 2006 NHS Act will remain unchanged in legislation, as it has since the founding NHS Act of 1946.
- 3. Is this a u-turn?
The listening exercise showed once again that there is broad support for the principles underpinning our reforms. These principles are not changing. We are not retreating on the need for a modernised NHS focused on patient involvement and shared decision making, with strong clinical leadership.
We have always been open to ways to improve our plans, and that is what we are doing. This is substantial change in order to better realise those principles.
- 4. Do you accept all of the recommendations of the Future Forum?
We welcome Professor Field's report and have agreed to accept all the core recommendations of the whole Forum.
- 5. The NHS Future Forum was a sham
45 independent-minded people said here are ways in which the Government got it wrong and recommended substantial changes.
- 6. What next for the Bill? It's wrong for you to rush it through
We remain committed to full Parliamentary scrutiny of the Bill. This is why we will be recommitting the relevant parts of the Health and Social Care Bill to a Public Bill Committee; exact details will be announced in due course. The Bill will of course also receive full scrutiny in the House of Lords.
- 7. Commissioning should be optional for GPs
All GP practices will be members of local clinical commissioning groups, but no individual GP will need to get involved in the work of a commissioning group if they don't want to.
- 8. By April 2013 some groups won't be ready and willing to take on commissioning budgets
Clinical commissioning groups won't be authorised to take on any of the commissioning budget in their local area until they are ready and willing to do so.
- 9. We're in a worse place now, with more clamps on competition than before?
Our changes will ensure competition works to improve quality for patients, making care more joined up and ensure the taxpayer isn't ripped off. Under Labour we had a system where the patient and the taxpayer got a bad deal. Private companies cherry-picked treatments and were paid more than the equivalent NHS cost.
- 10. You claim to be diluting Monitor's competition role yet have you kept its powers to enforce EU competition
The Bill itself does not extend the reach of EU competition law.
- 11. This is still a massive big bang
No; it's now very clearly evolution not revolution. A much more phased transition - for example, for clinical commissioning groups, for Strategic Health Authorities, for Monitor, for the introduction of Any Qualified Provider, for the abolition of NHS trusts.
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