Conservative Diary

« The new Prevent policy won't succeed without an enforcer. I nominate Lord Carlile. | Main | Is the Government as localist as we are led to believe? »

David Cameron begins to explain the changes he will make to the NHS Bill

By Jonathan Isaby
Follow Jonathan on Twitter

Picture 23

David Cameron has just given his widely trailed speech about the NHS in advance of next week's reporting back by the NHS Future Forum, the group tasked with overseeing the listening exercise on the Coalition Government's NHS reforms.

The Prime Minister said he didn't want to pre-empt the report and that the vision for the NHS remains the same, but that there were some details that he would want to change in the legislation. He gave five guarantees as widely briefed to the media in advance:  

  1. We will not endanger universal coverage – we will make sure it remains a National Health Service.
  2. We will not break up or hinder efficient and integrated care – we will improve it. 
  3. We will not lose control of waiting times– we will ensure they are kept low.
  4. We will not cut spending on the NHS – we will increase it.
  5. And if you’re worried that we are going to sell-off the NHS and create some American-style private system - we will not.

But here are the key excerpts from the text of the speech with the main indications of the changes to come in bold:

Protecting the princple of the NHS: "Let me be clear: as long as I’m Prime Minister, yes, there will be, as there are now, private providers and voluntary providers. But let me also be clear, no: we will not be selling off the NHS, we will not be moving towards an insurance scheme, we will not introduce an American-style private system. In this country, we have this most wonderful, precious institution and idea. That whenever you’re ill, however rich you are, you can walk into a hospital or surgery and get treated for free. No questions asked. No cash asked. I will never put that at risk.

Competition: "As our legislation currently stands, Monitor, the health regulator, has a duty to promote competition. This could be misinterpreted and we don’t want any doubt in anyone’s mind. Monitor’s main duty is to protect and promote the interests of people who use health care services and it will use competition as a means to that end. Not simply to promote it or prevent it, but to secure the services patients need. It will be tasked with creating a genuine level playing field, so the best providers flourish and patients get a real choice. And when I say that, I mean it. I mean a genuine level playing field. That’s why we will look to make sure private companies are only paid for the services they provide and that they contribute to the costs of training NHS staff. I mean only the ‘best’ providers. Every provider will need to meet the highest quality standards. And I mean a real choice for patients."

The NHS and integrated care: "We will make sure local commissioning only goes ahead when groups of GPs are good and ready, and we will give them the help they need to get there. And the NHS Commissioning Board will oversee commissioning on behalf of the Secretary of State. One organisation, working to one mandate, and responsible for delivering a clear set of outcomes across the country, providing the support to local commissioners, and carrying out commissioning themselves where necessary. So that is why our plans will now mean: A genuine National Health Service, underpinned by clear, national quality standards which delivers high quality care for all".

"We will not break up or hinder efficient and integrated care, we will improve it. And that means making changes to our current proposals. Hospital doctors and nurses will be involved in clinical commissioning.

"We will also introduce clinical senates where groups of doctors and healthcare professionals come together to take an overview of the integration of care across a wide area.

"And that’s not all. Monitor will now have a new duty to support the integration of services – whether that’s between primary and secondary care, mental and physical care, or health and social care. And health and well-being boards will help this further. They will bring together everyone from NHS commissioning groups to adult social care specialists, children’s trusts and public health professionals to design local strategies for improving health and social care integration."

Waiting times: "We’re keeping the 18 week limit. That's in the NHS contract and constitution. And it’s staying... And we’re not going to lose control of waiting times in A&E either... Yes, we’ll continue to measure how long people are kept waiting in A&E. Nurses and doctors said we should – and that’s what we’re doing. But the difference is that we’re going to measure outcomes too, like re-attendance rates for the same problem."

NHS spending: "There will be no cuts in NHS spending. Let me be absolutely clear. This year, and the year after, and the year after that, the money going into the NHS will actually increase in real terms with £11.5 billion more in cash for the NHS in 2015 than in 2010. I repeat: we are not cutting the NHS. In fact, we are spending more on it."


You must be logged in using Intense Debate, Wordpress, Twitter or Facebook to comment.