We are disappointed that many of our concerns still remain to be addressed,’ said RCGP chairwoman Dr Clare Gerada.
‘The RCGP will use the opportunity of the scrutiny the Bill will receive the House of Lords to continue to press for change and additional clarity.
‘The College supports putting clinicians at the centre of planning health services. However, we continue to have a number of concerns about the government's reforms, issues which we believe may damage the NHS or limit the care we are able to provide for our patients.
‘These concerns have been outlined and reiterated pre- and post-pause.
‘As a College we are extremely worried that these reforms, if implemented in their current format, will lead to an increase in damaging competition, an increase in health inequalities, and to massively increased costs in implementing this new system.
‘As independent research demonstrates, the NHS is one of the most efficient healthcare systems in the world and we must keep it that way.’
GPC chairman Dr Laurence Buckman said: ‘Although there has been a bit of movement in some areas we’re disappointed that MPs didn't grasp their final opportunity to make the sort of major amendments to the Health Bill that we’d like to have seen. However, it’s not over yet – we know many of the Lords share our concerns about this flawed Bill and the BMA will be using every opportunity available in the coming months to make sure doctors’ concerns are heard.’
Medical Practitioners' Union
I am extremely disappointed but not surprised,' said Medical Practitioners' Union (MPU) president Dr Ron Singer. 'I expected Tory MPs to vote for the Bill but I am again disappointed that there was no fight from Liberal Democrat MPs, whose party is still officially opposed to many aspects of the Bill.
'The prime minister’s attempt both in parliament and last week to imply that health workers and royal colleges are now fully supportive of the Bill is disgraceful and shows the low standards that are being applied to the spin of the Bill, at the expense of ignoring what will be disastrous effects on the NHS.
'The MPU has evidence from the more than 500 GPs who signed our petition saying they were taking part in commissioning as a defensive move, not because they supported it.
'I was hoping that in this parliamentary democracy there would be an inkling of a fight, but everybody seems to be leaving it up to the Lords to conduct that fight.'
This is an important step in implementing clinical commissioning,' said NHS Alliance GP Commissioning Federation national co-lead Dr Shane Gordon.
'The critical part in the passage of the Bill is the transfer of responsibility and accountability for local health system to the clinicians that serve it. It is now up to GPs and other clinicians to really get this working, but this is already happening.
'The Bill will give the right levers to local leaders to get the improvement in the health service needed by their local population.'
Dr Gordon said critics of the Bill were wrong to worry about privatisation of the NHS. 'I want a serivces that is high quality, free at the point of access, funded by taxation. There are already a large number of private providers working under that system. To all intents and purposes they look and feel the same as what we would traditionally have called NHS providers.'
He added that profit margins for private companies in the healthcare sector were generally 'slim'. 'I don’t think there is an opportunity for massive profiteering, particularly when there is a national tariff arrangement.'
National Association of Primary Care
NAPC president and DoH national clinical commissioning network lead Dr James Kingsland said: 'I am relieved, and not unsurprised that it only took two more days back in the Commons. The debate could have taken longer.
'My sense that there is growing cross-party support – we haven’t got an alternative and we’ve now gone a long way down this path.
'Politicians have taken a pragmatic approach. It would have been difficult to understand after the almost unprecedented listening exercise and amendments during the passage of the Bill, to create further delay.
'There has to be a credible alternative – the BMA is saying "scrap the bill", but I’ve not seen a credible altenative that delivers the productivity and efficiency challenge. This is a late stage to be saying "scrap the bill" without a credible alternative.'
He added that critics of the Bill seemed often to support the general principles behind it. 'I hear people say: "We want a patient-centric NHS, we want more contol, we want better outcomes and efficiency but we don’t like the reforms." But the reforms are all about that. The devil is in the detail, but if we get the principles right, process and structures should be secondary in an NHS in which we will struggle if we don't do something dramatic.'
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