Health Secretary Andrew Lansley could be modifying his plans for reforms this week in an attempt to prevent a cross-party revolt among critics who fear that the changes would lead to the fragmentation of the NHS.
The plans would be on the table for further discussion and Andrew Lansley would be obliged to maintain the NHS as a national public service and, his critics say, and limit his ambitions to expand the role of the private sector. The changes will also spell out the kind of services that must be offered by GPs and will effectively ban them from withholding certain forms of care from patients.
Mr Lansley insisted that the NHS was delivering efficiency savings and improvements for patients following a warning from MPs that the overhaul of the NHS is hindering efforts to slash health spending without cutting vital services. “I think the select committee's report is not only out of date but it is also, I think, unfair to the NHS, because people in the NHS, in hospitals and in the community services are very focused on ensuring that they deliver the best care to patients and that they live within the financial challenges that clearly all of us have at the moment,” Mr Lansley told ITV Daybreak. “I am afraid the evidence points to the fact that they are doing that extremely well.”
On Saturday Labour's health spokesman in the House of Lords, Baroness Thornton, described the move as a “massive climbdown” by Lansley. But she said the bill still remained deeply flawed and that attention would turn to clauses dealing with plans to increase competition when it returns to the Lords next month. The peers, led by the Lib Dem, Baroness Williams, and supported by a former Tory lord chancellor, Lord Mackay of Clashfern, have complained that the original bill left serious legal doubt as to whether the secretary of state would any longer be responsible for providing a “comprehensive health service for the people of England free at the point of need”. They expressed concern at the absence of a chain of accountability that would allow the service to become fragmented as different groups of doctors adopted different approaches and the role of the private sector expanded.
Meanwhile, opposition from doctors to the bill appears to be growing. The Royal College of Physicians, which represents hospital doctors, is under pressure from members to hold an emergency general meeting. The members want it to follow the British Medical Association, the Royal College of Nursing and the Royal College of Midwives in calling for the bill to be scrapped. The body representing NHS radiologists, Royal College of Psychiatrists are all united in their protests.
Andy Burnham, the shadow health secretary, said on Saturday that there had been “sheer panic” at the Department of Health. “But no amount of pressurizing phone calls and desperate concessions will make the bill acceptable,” he said.
The Department of Health confirmed the changes would be made to the bill but denied they were a panic response following a fortnight in which Lansley's approach has been criticized by a cross-party group of MPs and a growing number of health professionals. A letter from the government health minister Lord Howe to a group of peers last week confirmed the changes. It said that “there seems to be an emerging consensus about how the bill can be improved in order to put beyond doubt the secretary of state's accountability for the health service”.