Clegg pledge over NHS shake-up concerns

Deputy Prime Minister Nick Clegg has promised to address concerns over the Government's controversial NHS reforms as MPs called for "significant changes" to the plans.

The cross-party Commons Health Committee urged a rethink of the proposals, with former Tory health secretary and committee chairman Stephen Dorrell saying it is not a case of merely recommending "minor tweaking" of the Health and Social Care Bill.

One of the points the committee stressed is that GPs should not be solely in charge of commissioning services for patients. However, Mr Clegg said he believed it was an "uncontroversial idea" to hand them more responsibility.

He told BBC Breakfast: "It is a rather good idea to have them in the driving seat, rather than unaccountable officials who are moving money around from one side of the desk to the other.

"But, yes, with responsibility must come more accountability, which is precisely why we will be looking at these concerns, and will be looking to amend the legislation to reflect that."

The Liberal Democrat leader said they would listen to "legitimate" concerns about the Bill, currently going through Parliament, and that there could be "substantial" changes to the legislation.

Mr Clegg said: "The NHS is not the Government's property. We want people to feel comfortable with the changes, which will strengthen, and not weaken, the NHS."

He added that "a number of very significant amendments and improvements" had already been made to the Bill.

Addressing concerns about competition, he said: "There isn't going to be a bargain-basement rush to the bottom, because there isn't going to be competition based on price."

Mr Clegg added: "We want to be very, very clear - we're not going to allow cherry-picking.

"We're certainly not going to allow vital parts of the NHS, like A&E, to be suddenly open to competition."

MPs on the committee recommended a much bigger role for nurses, specialists and social care chiefs in deciding how services should be designed, together with tighter systems of governance and accountability.

All NHS commissioners - who would be GPs under the Bill's proposals - should have a board chaired by an independent person as well as a chief executive and finance director, they recommended.

The boards should be forced to meet in public, and measures put in place to ensure no conflict of interest as a result of GPs commissioning services from private firms in which they have a stake.

The name "GP consortia" to represent groups buying services should be scrapped, and renamed "NHS Commissioning Authorities", their report said.

This would reflect an expanded role for other health professionals in commissioning, including nurses and hospital doctors.

As a result of the changes put forward by the committee, Health and Wellbeing Boards in the Bill could be scrapped, the report said.

The committee also called for commissioners to have a legal obligation to consult patients through HealthWatch, an organisation designed to ensure local views are taken into account.

Their report today comes as Mr Clegg and Prime Minister David Cameron prepare to launch a "listening exercise" this week in a bid to reassure critics of the shake-up.

Health Secretary Andrew Lansley has admitted some groups have "genuine concerns" about the plans, including the speed of the changes, and was forced to make a Commons statement yesterday to defend aspects of the Bill.

He said the Government would take the opportunity of a "natural break" in the passage of the Bill to "pause, listen and engage" over the concerns and bring forward amendments to "improve the plans further".

Labour leader Ed Miliband has branded the Government's health reforms "extremely dangerous", and unions are opposed to many parts of the Bill, particularly those which aim to promote more competition between the NHS and private companies.

Mr Dorrell said there had been "spirited discussions" among committee members about competition in the NHS, but they all agreed commissioners and patients should have choices.

He said the changes set out in the report would create structures which were "more fit for purpose", and would help meet the Government's demand that the NHS find £15 billion to £20 billion a year in efficiency savings.

It was "beyond argument" that groups of commissioners, each responsible for roughly £20 million of taxpayers' money, should have proper governance and be held fully accountable, he said.

And he argued that calling commissioning bodies "GP consortia" was "misleading" and "over-emphasised" the role of GPs.

Furthermore, it was "odd for a Government that wants to encourage local decision-making" to produce a Bill where local bodies would not have any power. Of the report's content, he added: "I do accept that this is not minor tweaking."

The Royal College of Physicians (RCP) welcomed the report, saying it hoped the Government adopted the recommendations.

The RCP has been calling for hospital doctors, public health specialists, nurses and local community representatives to sit alongside GPs in NHS commissioning.

President Sir Richard Thompson said: "The RCP welcomes the report and wants to see 'commissioning without walls' - where a broad range of clinicians are fully involved in the commissioning process.

"However, although the Government supports this, currently the Bill provisions are too loose, leaving involvement of clinicians dependent on local relationships alone.

"Without further specific legislation, there is a risk of fragmentation of services and damage to patient care."

Cathy Warwick, general secretary of the Royal College of Midwives, said: "GPs are highly qualified but are on the whole generalists. To commission services effectively and appropriately they will need the expertise and input of people who know their particular field.

"I would, though, have liked to see midwives referenced specifically as one of those key professionals."

Nigel Edwards, acting chief executive of the NHS Confederation, said: "We absolutely agree with the committee's view that the accountability of GP consortia must be radically improved.

"We need a comprehensive and clear governance structure that has the confidence of patients and the public."

Len McCluskey, general secretary of the Unite union, said: "The committee raises profound questions about the Government's competence when it comes to the NHS. It rightly warns that massive £20 billion cuts to health spending at a time of rising care demands is a fundamental challenge to the NHS's operations."

Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said: "We have long said that no single profession can have sole responsibility for commissioning healthcare, and without a mix of healthcare professionals - including nurses - we believe that the new model of commissioning will fail."

Suggested Topics
Arts and Entertainment
Sheridan Smith as Cilla Black and Ed Stoppard as her manager Brian Epstein
tvCilla Episode 2 review: Grit under the glamour in part two of biopic series starring Sheridan Smith
Sport
David Moyes and Louis van Gaal
football
News
Former Governor of Alaska Sarah Palin, left, with her daughter, Bristol
newsShe's 'proud' of eldest daughter, who 'punched host in the face'
Sport
New Zealand fly-half Aaron Cruden pictured in The Zookeeper's Son on a late-night drinking session
rugby
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
News
A cabin crew member photographed the devastation after one flight
news
Life and Style
Carol O'Brien, whose son Rob suffered many years of depression
healthOne mother's story of how London charity Maytree helped her son with his depression
Life and Style
food + drink
Arts and Entertainment
The cover of Dark Side of the Moon
musicCan 'The Endless River' carry on the tradition? See for yourself
News
Rob Merrick's Lobby Journalists were playing Ed Balls' Labour Party MPs. The match is an annual event which takes place ahead of the opening of the party conference
newsRob Merrick insistes 'Ed will be hurting much more than me'
Voices
A new app has been launched that enables people to have a cuddle from a stranger
voicesMaybe the new app will make it more normal to reach out to strangers
News
Liam Payne has attacked the media for reporting his tweet of support to Willie Robertson and the subsequent backlash from fans
peopleBut One Direction star insists he is not homophobic
Life and Style
healthFor Pure-O OCD sufferers this is a reality they live in
Life and Style
Sexual health charities have campaigned for the kits to be regulated
healthAmerican woman who did tells parents there is 'nothing to be afraid of'
Life and Style
fashion
Arts and Entertainment
The John Peel Lecture has previously been given by Pete Townshend of The Who, Billy Bragg and Charlotte Church
musicGodfather of punk will speak on 'free music in a capitalist society'
News
peopleAt least it's for a worthwhile cause
News
Shoppers in Covent Garden, London, celebrate after they were the first to buy the iPhone 6, released yesterday
tech
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Pharmaceutical Computer System Validation Specialist

    £300 - £350 Per Day: Clearwater People Solutions Ltd: Pharmaceutical Computer ...

    High Level Teaching Assistant (HTLA)

    £70 - £90 per day: Randstad Education Birmingham: Higher Level Teaching Assist...

    Teaching Assistant

    £50 - £80 per day: Randstad Education Birmingham: Randstad Education is the UK...

    Senior Java Developer - API's / Webservices - XML, XSLT

    £400 - £450 Per Day: Clearwater People Solutions Ltd: Our client is currently ...

    Day In a Page

    A roller-coaster tale from the 'voice of a generation'

    Not That Kind of Girl:

    A roller-coaster tale from 'voice of a generation' Lena Dunham
    London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

    London is not bedlam or a cradle of vice

    In fact it, as much as anywhere, deserves independence
    Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

    Vivienne Westwood 'didn’t want' relationship with McLaren

    Designer 'felt pressured' into going out with Sex Pistols manager
    Jourdan Dunn: Model mother

    Model mother

    Jordan Dunn became one of the best-paid models in the world
    Apple still coolest brand – despite U2 PR disaster

    Apple still the coolest brand

    Despite PR disaster of free U2 album
    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments