Experts demand changes to NHS plans

The Government's plans for the NHS must undergo significant changes to secure the future of the health service, experts said today.

The aim of improving services is universally supported but there are "genuine and deep-seated concerns" which need to be addressed, the NHS Future Forum, appointed by the Government to review its plans, said.



The Health and Social Care Bill is currently on hold on its passage through Parliament after Prime Minister David Cameron announced a "pause" for reflection.



The Bill has attracted criticism from the medical profession and unions, particularly over increasing competition between the NHS and private companies.



Over the last two months, members of the forum have met more than 6,700 people face to face and have received more than 29,000 emails, comments and questionnaires.



The Government will officially respond to the report tomorrow, but Prime Minister David Cameron has already outlined "real changes" to the reforms - pre-empting the content of the report.



Key recommendations include:



:: Altering the role for NHS regulator, Monitor. The Bill originally said Monitor's primary duty should be to promote competition. This must now be "significantly diluted" and amended to require Monitor to support choice, collaboration and integration. Monitor should be seen as a sector regulator for health, not an "economic regulator".



:: Private firms should not be allowed to "cherry pick" patients and "the Government should not seek to increase the role of the private sector as an end in itself". The concept of any qualified provider in healthcare will remain, although companies will not be able to compete on price.



:: The Health Secretary must be ultimately accountable for the health service. The Bill should be amended to make sure this responsibility stays in place.



:: Increased transparency about how the NHS runs, including the decisions made by GP consortia, who will take control of £60 billion of the NHS budget.



:: GP consortia must take advice from different professionals, including hospital doctors. Clinical senates of NHS staff from different specialties should be established to provide "strategic advice".



:: The deadline of 2013 for consortia to take on responsibility for commissioning should be scrapped in favour of a more fluid timescale.



Publishing the findings, NHS Future Forum chairman Professor Steve Field said the NHS would be in a "strong position" to tackle future challenges, including an ageing population, if the Government accepted its recommendations.



"There is no doubt that the NHS needs to change," he said.



"The principles underlying the Bill - devolving control to clinicians, giving patients real choices and control, and focusing on outcomes - are well supported.



"However, during our listening we heard genuine and deep-seated concerns from NHS staff, patients and the public which must be addressed if the reforms are to be progressed.



"If the substantial changes we propose are accepted by Government, then I think the resulting framework will place the NHS in a strong position to meet this objective and tackle the pressing challenges in the years ahead."



The report calls for patients to be at the heart of reform and says they want choice over care and treatment which extends beyond which hospital they attend.



The new NHS Commissioning Board should therefore be given a "choice mandate" while a new citizens panel should report to Parliament on how well it has been implemented.



Further work should also be done to give citizens a new "Right to Challenge" poor-quality services and lack of choice.



A new duty should be put on the NHS Commissioning Board and GP consortia actively to promote the NHS Constitution, which sets out patient rights, including on waiting times.



And while it is important that competition is not used for the sake of it, it is "important to promote a diversity of providers".



Mr Cameron has agreed to curbs on cherry-picking, a bigger role for medics other than GPs, a slimmed-down role for Monitor and for the 2013 deadline to be scrapped.



Aides to the Prime Minister have insisted he was the driving force behind the policy rethink, but many Tory backbenchers are furious that Health Secretary Andrew Lansley has been "hung out to dry" to appease Lib Dems.



Deputy Prime Minister Nick Clegg will tell his party tonight he ensured their "voice was heard" and the new package is a "job well done".



Mr Lansley said: "The forum has been an invaluable source of expert advice and I have said we must keep listening on the NHS to deliver a world-class health service.



"The forum's reports show clear support for a health service that puts patients at the heart of everything it does, and where services are joined up, accountable and focus on delivering better results for patients.



"The forum's approach is one on which we can build a strong NHS for the future."



Dr Hamish Meldrum, chairman of the British Medical Association (BMA), said the report had addressed many concerns but some still remained.



He added: "Obviously, the critical factor is now how the Government responds, as well as ensuring that the detail of the changes matches up to expectations.



"But if the Government does accept the recommendations we have heard today we will be seeing, at the least, a dramatically different Health and Social Care Bill and one that would get us on to a much better track."



Chris Ham, chief executive of the King's Fund, said the recommendations would "significantly improve" the Health and Social Care Bill but it was now time to move on with the reforms.



Dave Prentis, general secretary of Unison, said big questions over critical issues such as privatisation remained unanswered.



"The forum is recommending sweeping changes to the Bill because it is riddled with flaws.



"It exposes the real agenda behind the Government's Bill - the wholesale marketisation of the NHS.



"It wants to turn our health service into nothing more than a logo on the side of a van run by a multinational company."



Shadow health secretary John Healey said: "The Future Forum report is a demolition job on the Tory-led Government's misjudgements and mishandling of the NHS over the past year.



"The big test is for David Cameron and whether he will fundamentally rewrite his NHS legislation and give up the long-term Tory plan to turn the NHS into a full-scale market.



"We will judge the Prime Minister on what he does, not what he says."



He added: "What Professor Field recommends can largely be achieved without the Government's legislation and without David Cameron's high-risk and high-cost reorganisation."













The plans affect the NHS in England.



Katherine Murphy, chief executive of the Patients Association, said: "The Patients Association cautiously welcomes the results of the NHS Future Forum, which proposes significant changes to the Health and Social Care Bill.



"We welcome the commitment to the NHS Constitution. The NHS Constitution is the contract between the NHS and patients that patients refer to.



"It is vital in guaranteeing patients' rights and without it many patients would be left unsure about what they should expect from the NHS.



"The role of Monitor and the place of competition within the NHS have been controversial since the reform plan was announced last July.



"Many of the patients who talked to us in our independent listening events and via our survey were concerned that this move would spell the end of a public NHS and was back-door privatisation.



"We agree that the Department of Health must move away from this overtly market-driven model and put measures in place to prevent companies from cherry-picking services.



"The NHS needs to be about collaboration and not competition."

Life and Style
ebookNow available in paperback
ebooks
ebookA delicious collection of 50 meaty main courses
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
SPONSORED FEATURES

ES Rentals

    Independent Dating
    and  

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

    iJobs Job Widget
    iJobs General

    Guru Careers: Tax Manager / Accountant

    £35 - £50k DOE: Guru Careers: A Tax Manager / Accountant (ACA / CA / CTA) is n...

    Recruitment Genius: Telemarketing Operative

    £6 - £15 per hour: Recruitment Genius: This is an opportunity to join a well e...

    Recruitment Genius: Data Scientist

    £20000 - £30000 per annum: Recruitment Genius: This is an exciting opportunity...

    Recruitment Genius: Full Stack Software Developer - Javascript

    £18000 - £27000 per annum: Recruitment Genius: This is an exciting opportunity...

    Day In a Page

    Turkey-Kurdish conflict: Obama's deal with Ankara is a betrayal of Syrian Kurds and may not even weaken Isis

    US betrayal of old ally brings limited reward

    Since the accord, the Turks have only waged war on Kurds while no US bomber has used Incirlik airbase, says Patrick Cockburn
    VIPs gather for opening of second Suez Canal - but doubts linger over security

    'A gift from Egypt to the rest of the world'

    VIPs gather for opening of second Suez Canal - but is it really needed?
    Jeremy Corbyn dresses abysmally. That's a great thing because it's genuine

    Jeremy Corbyn dresses abysmally. That's a great thing because it's genuine

    Fashion editor, Alexander Fury, applauds a man who clearly has more important things on his mind
    The male menopause and intimations of mortality

    Aches, pains and an inkling of mortality

    So the male menopause is real, they say, but what would the Victorians, 'old' at 30, think of that, asks DJ Taylor
    Man Booker Prize 2015: Anna Smaill - How can I possibly be on the list with these writers I have idolised?

    'How can I possibly be on the list with these writers I have idolised?'

    Man Booker Prize nominee Anna Smaill on the rise of Kiwi lit
    Bettany Hughes interview: The historian on how Socrates would have solved Greece's problems

    Bettany Hughes interview

    The historian on how Socrates would have solved Greece's problems
    Art of the state: Pyongyang propaganda posters to be exhibited in China

    Art of the state

    Pyongyang propaganda posters to be exhibited in China
    Mildreds and Vanilla Black have given vegetarian food a makeover in new cookbooks

    Vegetarian food gets a makeover

    Long-time vegetarian Holly Williams tries to recreate some of the inventive recipes in Mildreds and Vanilla Black's new cookbooks
    The haunting of Shirley Jackson: Was the gothic author's life really as bleak as her fiction?

    The haunting of Shirley Jackson

    Was the gothic author's life really as bleak as her fiction?
    Bill Granger recipes: Heading off on holiday? Try out our chef's seaside-inspired dishes...

    Bill Granger's seaside-inspired recipes

    These dishes are so easy to make, our chef is almost embarrassed to call them recipes
    Ashes 2015: Tourists are limp, leaderless and distinctly UnAustralian

    Tourists are limp, leaderless and distinctly UnAustralian

    A woefully out-of-form Michael Clarke embodies his team's fragile Ashes campaign, says Michael Calvin
    Blairites be warned, this could be the moment Labour turns into Syriza

    Andrew Grice: Inside Westminster

    Blairites be warned, this could be the moment Labour turns into Syriza
    HMS Victory: The mystery of Britain's worst naval disaster is finally solved - 271 years later

    The mystery of Britain's worst naval disaster is finally solved - 271 years later

    Exclusive: David Keys reveals the research that finally explains why HMS Victory went down with the loss of 1,100 lives
    Survivors of the Nagasaki atomic bomb attack: Japan must not abandon its post-war pacifism

    'I saw people so injured you couldn't tell if they were dead or alive'

    Nagasaki survivors on why Japan must not abandon its post-war pacifism
    Jon Stewart: The voice of Democrats who felt Obama had failed to deliver on his 'Yes We Can' slogan, and the voter he tried hardest to keep onside

    The voter Obama tried hardest to keep onside

    Outgoing The Daily Show host, Jon Stewart, became the voice of Democrats who felt the President had failed to deliver on his ‘Yes We Can’ slogan. Tim Walker charts the ups and downs of their 10-year relationship on screen