Listening pause yields competition defeat
By Alex Stevenson Follow @alex__stevenson
Competition's role in the coalition's NHS reforms will be significantly watered down if the government accepts today's recommendations.
The NHS Future Forum has issued 16 recommendations after conducting an unprecedented 'listening pause' in the health and social care bill's passage through parliament.
Ministers had already abandoned price competition, but intense opposition from within the health sector prompted the government to think again.
The bill had proposed to require regulator Monitor to promote competition. That has been removed completely, in a major victory for health campaigners. Instead Monitor will be required to "support choice, collaboration and integration".
Rather than GP consortia being forced to begin commissioning services by 2013, the pace of the proposed changes will be varied so implementation only takes place when the various parts of the NHS are ready to do so.
Original plans had proposed making GPs solely responsible for commissioning. Now nurses, specialist doctors and other clinicians will be involved in making local decisions about the commissioning of care.
Professor Steve Field, who had overseen the NHS Future Forum's work, said the principles underlying the health and social care bill were well-supported.
"However, during our listening we heard genuine and deep-seated concerns from NHS staff, patients and the public that must be addressed if the reforms are to be progressed," he said.
"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.
Ministers will offer their response to the NHS Future Forum's findings tomorrow.
Prof Field called for debate over the future of the NHS reforms to cease, saying he hoped the issue would no longer be a "political football".
"We believe the time for political argument is coming to an end," he added.
"Now we urge politicians to work together to take the NHS forward. If we can do that, this will be a victory for our patients, for the public and the staff of the NHS."
Concerns about accountability have resulted in firmer assurances that health and wellbeing boards will be given greater powers to ensure the needs of the local population are being met.
The health secretary will remain ultimately accountable for the NHS – an assurance which was not originally in the bill.
The King's Fund, the respected health thinktank, said the emphasis on integration was particularly significant because it enabled greater collaboration between NHS services.
"By strengthening collaboration and improving the co-ordination of services, integrated care offers the most promising approach to meeting the challenges posed by demographic change and the increasing numbers of people with long-term conditions," chief executive Chris Ham said.
"Despite the headlines generated by the reforms, the key priority facing the NHS remains the need to find up to £20 billion in productivity improvements to maintain quality and avoid significant cuts in services.
"Implementing the reforms while maintaining the focus needed to achieve this will be very challenging and will require leadership and management of the highest quality throughout the NHS."
Shadow health secretary John Healey called the NHS Future Forum report a "demolition job".
"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.
"What Professor Field recommends can largely be achieved without the government's legislation and without David Cameron's high-risk and high-cost reorganisation."
