Lansley announces pause in reforms

Health secretary Andrew Lansley has told the House of Commons that he will take advantage of a “natural break” in the passage of the Health Bill through Parliament to undertake further consultation.

In a statement on Monday afternoon, Lansley indicated that there would be a delay before the Bill – which has just completed its committee stage – came back to the Commons.

He also indicated that the additional time would be used to drum up support for the Bill, which has come under fire from managers, doctors, think-tanks and the Labour opposition.

However, he gave few details of what the additional consultation would look like, how any changes would be introduced, or what concessions the government is inclined to make.

He did acknowledge that concerns about the latest round of reorganisation and reform had coalesced around a number of issues since the ‘Liberating the NHS’ white paper was published last summer.

He said people were concerned about competition, and indicated that some services – such as A&E – might be protected, while the private sector was prevented from “cherry picking” others. He also said people were concerned that GP commissioning should be open and transparent.

Overall, though, Lansley insisted that “no change is not an option” and the pressure of ageing, new technology and rising costs had to be met by moves to raise productivity and cut bureaucracy.

The health secretary’s statement came at the end of several months of rising opposition to the Health Bill, not least by the Liberal Democrats at their spring conference and the British Medical Association at its recent Special Representative Meeting.

On Monday, the Royal College of GPs announced that it will write to Lansley to ask him to review key aspects of the Bill, including its plans to allow ‘any willing provider’ to provide services and to encourage the regulator, Monitor, to promote competition.

Dr Clare Gerada, chair of the RCGP, told EHI Primary Care that it had already written to the health secretary about plans to abolish practice boundaries, which it fears will fragment in-hours and out-of-hours care and adversely affect GP record keeping.

The Policy Exchange think-tank also added to the long-list of reports calling for a slower pace of change; although its concern is that a failure to take GPs with the reforms will lead to less change in commissioning and less use of the private sector than it would like to see.

Lansley took time in his statement to pay tribute to the improvements made by the NHS in some areas in recent years, and to praise staff for cutting waiting times, improving cancer care and addressing the MRSA ‘super-bug.’

He also stressed that the government will inject £11.5 billion into the NHS over the lifetime of the current Parliament – although this will not protect it from needing to find £20 billion of ‘efficiency savings’ – and that the GP commissioning aspect of the reforms are already under way.

Last week, the government announced the fourth round of ‘pathfinder’ GP commissioning consortia. This allowed Lansley to claim that 220 groups are now in place, and that 45m people in Britain are now served by GPs who want to take part in “improving services for their patients.”

Over the weekend, a number of newspapers reported that prime minister David Cameron was taking a bigger interest in the reforms, because of their potential to generate public opposition and splits in the coalition.

Labour’s shadow health secretary, John Healy, picked up on this in the Commons and asked Lansley why Cameron had not made the statement. He also said the Bill needed not a pause but “radical surgery” to remove its “fundamental flaws.”