NHS reform delay 'not a gimmick'

Nick Clegg claimed today the listening exercise for NHS reforms was "not a gimmick" and said the Government would make significant changes to legislation.

The Deputy Prime Minister talked with patients to discuss concerns over the changes - which would put groups of GPs in charge of commissioning services - while the architect of the shake-up, Health Secretary Andrew Lansley, will meet potential GP consortia.

The events are the first of a series of forums set up after the Government declared a "pause" in the parliamentary passage of the legislation implementing the package amid fierce criticism.

Meanwhile, the Government faces accusations from MPs of having "no control" over many of the costs of the reforms.

A report by the influential Public Accounts Committee warned that pushing through the changes while seeking £20 billion in efficiency savings could put patient care at risk.

The concerns were raised in a report into the controversial changes that are threatening to drive a wedge between the Conservatives and Liberal Democrats.

One of Mr Clegg's closest advisers, Norman Lamb, has already hinted he could quit unless implementation of the package is slowed down.

Speaking at the forum held at the Chelsea and Westminster Hospital in London, Mr Clegg admitted the coalition had not "successfully won the argument".

"We haven't yet persuaded enough people in the NHS and elsewhere that what we're trying to do is good for the NHS," he said.

"We've taken this unusual step to do precisely that. To stop, and to listen, and to learn.

"Let me stress this, it's not a gimmick, it's not a PR exercise. We will make changes, we'll make significant and substantive changes to the legislation which at the moment is - if you like - it's suspended in the House of Commons in order to make sure that those who perhaps develop some very serious and legitimate doubts about some of the details of the plans feel that it's now on the right track again and then we can move forward together."

The Public Accounts Committee report says 40% of the planned efficiency savings are under national control, through pay freezes, central budget cuts and management cost reductions.

A further 40% are due to come from efficiencies at health providers. But the "most difficult to achieve" will be 20% from service reforms - such as delivering care in the community rather than hospitals.

The MPs warn that Department of Health (DoH) estimates for the £1.4 billion transition costs rely on GP commissioners being willing to take on a proportion of primary care trust staff after the bodies are abolished.

"The department has no control over such decisions or the resultant redundancy costs," the report stated.

"The department needs to regularly review the emerging costs of the transition and have contingency arrangements in place if costs exceed expectation."

Committee chairman Margaret Hodge said: "The department must have effective systems in place to deal with failure so that, whatever happens, the interests of both patients and taxpayers are protected.''

Mr Clegg failed to convince several Chelsea and Westminster Hospital patients that the forum would have an impact.

Chris Birch, a patient governor at the hospital, told the Lib Dem leader he doubted the quality of care would be improved by the "upheaval" proposed.

He said after the event: "I've no idea to what extent what was said will be taken onboard and acted upon. In fact I'm sceptical as to whether it will be."

Technology consultant Mark Phillips added: "It's certainly interesting, there was some listening going on, but ultimately what can anybody do in a 50-minute session with a small room of people?

"How is that going to change the juggernaut that is this Bill in progress?"

Alex Marino, who attended the event with her baby Isabella, said: "I'm not convinced it will have much effect at all.

"It's difficult to know whether it's just a nice publicity measure or how much they really take to heart each person's concerns."