Pledge that hospitals will improve care for the elderly

Hit squads are to be sent into hospitals in an attempt to drive up standards of treatment for the elderly – with checks on conditions in care homes likely to follow.

Plans for the biggest overhaul of the National Health Service for decades, to be announced this week, will set out moves to beef up its complaints system. As a first step, senior nurses will carry out spot checks on hospital wards treating elderly people, focusing on whether patients are treated with dignity and respect and are served nutritious food.

The Department of Health confirmed last night it was drawing up proposals to extend the regime of unannounced visits to social care providers.

The Independent columnist Johann Hari last week detailed the mistakes and incompetence endured by his grandmother as she was moved between care homes in the last 10 years of her life.

The Care Services minister, Paul Burstow, responded to Hari's article by promising tougher protection for the elderly against abuse.

Moves to restructure the NHS will be detailed in the Government's Health and Social Care Bill, which is due to be published on Wednesday. The 152 English primary care trusts will be abolished and their responsibility for commissioning £80bn of treatment and services – four-fifths of the NHS budget - will be transferred in 2013 to groups of GPs.

The Bill will also include plans to make it easier to register complaints about poor-quality care.

The planned shake-up of health funding is already proving highly controversial, with the NHS Confederation warning it will lead to hospital closures, poorer care and rationing of treatment.

The organisation, which represents health service organisations, such as hospitals and primary care trusts, will say in a report this week: "The absence of any compelling story about why the reforms are necessary or how they will translate into improved outcomes is of concern."

It is "extraordinarily risky" to undertake such a fundamental restructuring when the NHS is being asked to save £20bn by 2014/15 and undergoing 45 per cent cuts in the number of managerial staff, it will warn.

Andy Burnham, the former Health Secretary, said yesterday that it was the wrong reform at the wrong time.

"These reforms threaten to unpick the fabric of our National Health Service. At just the moment when the NHS faces a huge financial challenge what do they do? They bring in a massive reorganisation on a scale that we have never seen before in the NHS," he told Sky News.

But David Cameron will reject the criticism in a wide-ranging speech today, insisting the Coalition is determined to transform public services by injecting greater competition and choice, as well as giving them greater freedom from central control.

He will insist that reform – a vital component of work to tackle the national deficit – has to begin as quickly as possible and that 2011 will be a vital year for his modernisation agenda.

As proof of the widespread support for change, he will disclose that 141 groups of GPs have already come forward to take part in trials of the new funding system. They are responsible for the care of 28.6m people in England, more than half of its population.

He will say he wants "one of the great legacies of this Government to be the complete modernisation of our public services".

The Prime Minister will say: "I don't want anyone to doubt how important this is to me. My passion about this is both personal and political.

"Personal because I've experienced, first-hand, how dedicated, how professional, how compassionate our best public servants are.

He will add: "This is a political passion – and priority – of mine too. I believe that Britain can be one of the great success stories of the new decade."

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