PM denies NHS bill 'disaster'


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David Cameron mounted a passionate defence of the coalition's controversial health reforms today despite the legislation being branded a "disaster".

The Prime Minister, whose disabled son Ivan died in 2009, said the shake-up was essential to ensure that everyone received the "amazing" care his family had.

He also dismissed suggestions that Health Secretary Andrew Lansley's job could be on the line over the issue.

The comments came during fiery exchanges at Prime Minister's Questions in the Commons.

With peers due to resume their scrutiny of the Health and Social Care Bill, Labour leader Ed Miliband urged Mr Cameron to "give up" on the changes.

"This is a matter of trust in the Prime Minister," he told MPs. "Can he honestly look people in the health service in the eye and say he's kept his promise of no more top-down reorganisation?"

Mr Miliband added: "He knows in his heart of hearts that this is a complete disaster. Why won't you just give up and stop wasting billions and drop your Bill?"

But Mr Cameron insisted GPs were not just "supporting our reforms, they are implementing our reforms".

"I care passionately about the NHS, not least because of what it has done for my family and because of the amazing service that I have received," he said.

"I want to see that excellent service implemented for everyone and that means two things: it means we have got to put more money into the NHS, and we are putting the money in, but it also means we have got to reform the NHS."

Speculation over Mr Lansley's position was fuelled yesterday when an unnamed Downing Street source was quoted saying the Health Secretary should be "taken out and shot" for mishandling the issue.

But Mr Cameron mocked Mr Miliband - who defeated brother David for the leadership - for lecturing on "happy families" in government.

"The career prospects for my right honourable friend (Mr Lansley) are a lot better than his," he joked.

The UK Faculty of Public Health today became the latest in a string of professional healthcare bodies to call for the Bill to be scrapped.

A survey of members found that 93% believed the Bill would damage the NHS and the health of people in England and three-quarters wanted the Faculty to demand its withdrawal.

Faculty president Professor Lindsey Davies said: "We are now calling on the Government to withdraw the Bill in its entirety, because it would be in the best interests of everyone's health.

"Our 3,300 members - experts in planning and providing for people's health - have been closely involved in trying to make the Government's proposed reforms work since they were first introduced.

"Based on our members' expert views, it has become increasingly clear that the Bill will lead to a disorganised NHS with increased health inequalities, more bureaucracy and wasted public funds.

"The Bill will increase health inequalities because there is the real danger that vulnerable groups like homeless people will not be included when health services are being planned. Clinical commissioning groups and service providers will be able to pick and choose what procedures they perform and which services they put in place."

The Faculty voiced concerns about how emergency planning, screening and immunisation services will work under the Bill, which it said would leave the NHS with a shortage of strategic leadership and a lack of clarity about what happens if a private provider goes bankrupt.

Prof Davies added: "We also face increasing costs for health services as the private sector will need to make a profit out of commissioning and running NHS services. This will use more taxpayers' money that could be used for patient care.

"At a time when the NHS needs to save £20 billion, this is an unaffordable and unnecessary burden on the NHS."

The Health Secretary was in the Commons for the weekly session, but some way from the Prime Minister at the far end of the front bench.

Mr Cameron is said to have reaffirmed his support for the Health and Social Care Bill at a meeting with Mr Lansley and Liberal Democrat leader Nick Clegg earlier this week.

The legislation is returning to the Lords less than a week after the Royal College of GPs wrote to Mr Cameron calling for it to be scrapped.

A poll of British Medical Journal (BMJ) readers found that more than 90% believed the reforms should be abandoned.

The Government has already accepted scores of amendments to the Bill, including a guarantee that the health secretary will remain ultimately responsible for providing NHS services in England.

More tension is expected today over the minister's specific duty to provide education and training throughout the service.

There are fears that the key issue of competition in the NHS may not be settled before next month's Liberal Democrat spring conference.

The scale of opposition at last year's event was partly responsible for the decision to "pause" and rethink the original proposals.

Sue Slipman, the director of the NHS Foundation Trust Network, warned that the health service will be left in "no man's land" if the Bill is not passed.

She told BBC Radio 4's World At One: "If the Bill crumbles now, we will be in no man's land. A lot of the old infrastructure is already passing away. We can't be without a system and a structure to work within.

"There are lots of things about the Bill that will need really hard work to make them work, but there are also reforms in there that we need to continue, particularly around the development of the NHS Trust model for public providers."

A group of 54 representatives of NHS Foundation Trusts signed a letter to The Times today, backing changes in the Bill which will allow them to earn up to 49% of their income from non-NHS sources.

Ms Slipman said: "This is a huge potential source of finance.

"Foundation Trusts will always have as their principal purpose serving NHS patients, and we need to begin to exploit intellectual property in the NHS with new products, with new services, with new drugs, that will bring money in to serve NHS patients.

"I think the public should have confidence in the fact that any money raised from these services will go to improve services and innovate in services that will serve NHS patients."

Reports earlier this week suggested that the idea had been floated within Number 10 of inviting Labour's former health secretary, Alan Milburn, to accept a peerage in order to replace Mr Lansley and take forward the job of reforming the NHS.

But Mr Milburn said today that he was not aware of any such offer and insisted there was "fat chance" of him accepting it.

He accused Mr Lansley of "bungling" the reforms and ending up with a "patchwork quilt of complexity, compromise and confusion" that would leave the NHS even more centralised than before.

"This Bill creates what I can only describe as the daddy of all quangos - a national NHS commissioning board that will be in charge of between £60-£80 billion worth of NHS money and will be making decisions not in local communities but in Whitehall," Mr Milburn told World at One.

"It is actually the biggest nationalisation since Nye Bevan created the NHS in 1948."

Mr Milburn said he expected the Government to get the Bill through Parliament in some form, but said the coalition would then have no appetite for the further reform that will be needed.

"It has managed to conflate in the public mind precisely the four words Mr Cameron wants desperately to avoid - 'cuts', 'privatisation', 'health' and 'Tory'," said Mr Milburn.

"I think there is a basis for consensual and radical reform, but I'm afraid that isn't going to happen with this Bill or under this Government.

"It's probably up to a future government to do this. The last thing the Government would now want to do, having got its fingers so badly burnt, is to embark on a further bout of NHSreform. Ironically, that's precisely what's needed for the good of the NHS."