Health Secretary Andrew Lansley's Health Bill, setting out reforms to the NHS, has now been published. Here GP tracks the responses from key health organisations.
|Click below to read reactions
||General Healthcare Group|
||The Royal College of Obstetricians and Gynaecologists|
|Royal College of Physicians
||The Nuffield Trust||The King's Fund|
|NHS Confederation||CBI||Pharmacy Voice|
The RCGP said it ‘makes sense’ for health professionals to be involved in the planning of services, but the proposals risk ‘destabilising the NHS and causing long-term harm to patient outcomes’.
RCGP chairwoman Dr Clare Gerada said 'we must guard against fragmentation and unnecessary duplication within a health service that is run by a wide array of competing public, private and voluntary sector providers, that delivers less choice and fewer services, reduces integration between primary and secondary care and increases bureaucratic costs'.
Patient choices as outlined in the Bill ‘run a risk of destabilising the NHS and causing long-term harm to patient outcomes’. The RCGP has also yet to receive sufficient evidence to be reassured the plans would prevent this from happening.
She concluded: ‘The NHS has for more than 60 years delivered a fair and efficient system of healthcare for millions of patients. We acknowledge that improvements can always be made, but we must work with the Government to protect the founding principles of the NHS; the stakes are too high to lose it now.’
The BMA said ploughing ahead with the reforms at the speed proposed was a ‘massive gamble’.
Dr Hamish Meldrum, chairman of council at the BMA, said: ‘The BMA supports greater involvement of clinicians in planning and shaping NHS services, but the benefits that clinician-led commissioning can bring are threatened by other parts of the Bill.’
He added: ‘Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients.
‘Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services.'
Royal College of Physicians
The Royal College of Physicians (RCP) supports the shift towards putting clinicians and patients in the driving seat but is concerned the Bill doesn’t require specialists to be at the heart of commissioning.
Sir Richard Thompson, president of the Royal College of Physicians, said: ‘The scale and pace of change – and the challenge of unprecedented efficiency savings - should not be underestimated. Neither should the risks if we get this wrong.’
Unison, the public sector union, called the Health Bill a ‘disaster’ of Titanic proportions’. Karen Jennings, head of health at Unison, said: ‘This Titanic health bill threatens to sink our NHS. The only survivors will be the private health companies that are circling like sharks, waiting to move in and make a killing.
‘Lansley has turned his back on the warnings from across the medical establishment that these changes are unnecessary, undemocratic and unlikely to deliver improvements in patient care. We need a U-turn from the Government.’
Unite’s national officer for health, David Fleming, said: ‘It is clear that one of the biggest influences on Tory ideology regarding health policy has been the massive and insidious lobbying by the private healthcare companies, which have opened their cheque books for David Cameron big-time.’
He added: ‘The GP consortia, the supposed vanguard of this so-called reform programme, will be juggling financial decisions with the help of the private healthcare companies they will buy-in, versus the needs of their patients – this is a stark conflict of interest. Patients should always come first.’
The Nuffield Trust
The Nuffield Trust said the planned reforms are ‘broadly in the right direction’ but they will have to be judged on the extent to which they deliver – with minimum disruption – sustained improvements to patient care during a period of major financial challenge for the NHS.
Dr Jennifer Dixon, director of the Nuffield Trust, said: ‘The NHS is at a fork in the road. It embarks on this period of reform with much strength but the pressures it faces over the next four years will continue to rise.
'Given the reforms over the past 20 years the Government’s decision to devolve more responsibility to the front line is logical. However, this approach carries significant risks in today’s financial climate and needs to be managed very carefully.’
General Healthcare Group
General Healthcare Group, the UK’s largest private hospital group, welcomed the proposed reforms and said it was 'only right' the NHS, private and third sector providers worked together in austere times.
Adrian Fawcett, chief executive of General Healthcare Group, said: ‘In our view, the challenge for instituting these reforms will be about maintaining the pace of change and how instability during the period of transition is minimised.’
The Royal College of Obstetricians and Gynaecologists
Allowing GP consortia to commission maternity services will impede creation of a high-quality service, warns the Royal College of Obstetricians and Gynaecologists (RCOG).
RCOG president Dr Tony Falconer said: ‘Our concern, at all times, must be that the women in our care have access to the best available services and RCOG will be monitoring standards as well as supporting their development.’
The King's Fund
The Bill signals the biggest shake-up of the NHS since its inception, the King’s Fund has said.
Chris Ham, chief executive of The King’s Fund, said: ‘The last decade has seen significant progress in the performance of the NHS. While ministers are right to stress the need for reform to make it truly world class, these gains are at risk from the combination of the funding squeeze and the speed and scale of the reforms as currently planned.’
Mr Ham added: ‘But, while the government’s reforms have the potential to improve the NHS, they will be implemented against the backdrop of the biggest financial challenge in its history.
'Finding the £20bn in efficiency savings needed to maintain services must be the overriding priority, so the very real risk that the speed and scale of the reforms could destabilise the NHS and undermine care must be actively managed.’
The NHS Confederation urged MPs to ‘forensically analyse’ the Health Bill.
NHS Confederation acting chief executive Nigel Edwards said: ‘We support the objectives behind this legislation but there are huge risks and major uncertainties associated with it.
‘The system is already geared up for change and we can not afford for these reforms to fail – the public will not forgive us. The focus in parliament has to be on making this work on behalf of patients.’
John Cridland, CBI director-general designate, said: 'We support the Government’s plans to modernise the NHS, because this will lead to better services for patients, and ensure taxpayers’ money is spent wisely.
'Allowing the best provider to deliver healthcare services, whether they are a private company or a charity, will spur innovation and choice. But bidders must be able to compete for contracts on a level playing field.'
Pharmacy Voice chief executive Rob Darracott, said: 'The NHS is about more than doctors, and GP commissioning has to be about more than GPs. The Health Secretary acknowledges that pharmacists have an important and expanding role in supporting better health, but we now need to see his words backed by action. Pharmacists see more people, more often, even than GPs do.’