NHS reforms in Norfolk

The region's GPs and health organisations last night indicated they were expecting changes in the government's plans for NHS reform, as ministers came under increasing criticism.

Health secretary Andrew Lansley admitted there were 'genuine concerns' that needed to be addressed and an influential committee of MPs became the latest body to call for 'significant changes' to the controversial proposals.

The cross-party Commons Health Committee is urging a rethink, saying GPs should not be solely in charge of commissioning services for patients and there needs to be a much bigger role for nurses, specialists and social care chiefs in deciding how services should be designed.

Tighter systems of governance and accountability, a legal obligation to consult patients through the new HealthWatch organisation and a new name for 'GP consortia' are among the changes recommended by the committee.

The committee's comments come as prime minister David Cameron and his deputy Nick Clegg prepare to launch a 'listening exercise' this week in a bid to reassure critics about the shake-up.

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In Norfolk, health bodies said they were still starting to implement the reforms, which would see primary care trusts abolished and GPs handed responsibility for commissioning health services, but admitted they were expecting changes and amendments.

Andy Evans, chief executive of HealthEast – the GP consortium for Great Yarmouth and Waveney – said as far as they were concerned, they were still working towards an April 2013 deadline to take over responsibility for the area's health services. He said: 'Given the nature of the health service reforms, we expect there to be a number of changes and amendments before we arrive at the final form.

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'We are expecting to be light on our feet for the next two years.'

He also welcomed the MPs' calls for other clinicians to be part of the consortia, saying HealthEast was already working closely with other health professionals to ensure their organisation was clinician-led rather than just GP-led. Mr Evans said HealthEast was now a formal sub-committee of NHS Great Yarmouth's board and under its delegated powers would start to assume responsibilities for finances and budget over the next four or five months.

Three more groups in West Norfolk, North Norfolk and Norwich have also started to shadow the work of the primary care trust and take on more responsibility for planning healthcare.

It is the speed of the reforms which has attracted some criticism, which is perhaps why Mr Lansley has agreed 'to pause, to listen and to engage' and it is also thought GPs will be given beyond the current April 2013 deadline.

In Norfolk, GPs were asked to meet an April 1 deadline this year to indicate which consortia they would be forming or joining, but already that deadline has slipped by and it is still unclear what will happen in the south of the county.

Ian Ayres, an executive director at NHS Norfolk, said: 'The formation of GP commissioning consortia is very much for the GPs themselves to lead and discussions are still taking place between GPs in the south of Norfolk.

'While national guidance was given on the timeframe for consortia to emerge, it is important that a complex process such as forming commissioning consortia must be allowed the space to play through. We anticipate we will hear the outcome of the discussions in south Norfolk in the weeks to come.'

Opponents have attacked the Health and Social Care Bill as a way of privatising the NHS.

Labour leader Ed Miliband yesterday branded the government's health reforms 'extremely dangerous' and unions are strongly opposed to many parts of the bill, particularly sections that aim to promote more competition between NHS and private companies.

Mr Lansley admitted there could be further improvements to the Bill when it came to opening up the NHS to private providers and promised they would not be allowed to exploit the new system and 'cherry-pick' the most profitable services.

Mr Lansley told the Commons: 'We recognise that this speed of progress has brought with it some substantive concerns. Some of those concerns are misplaced or based on misrepresentations, but we recognise that some are genuine. We want to continue to listen to, engage with and learn from experts, patients and frontline staff within the NHS and beyond and to respond accordingly.

'I can, therefore, tell the House that we propose to take the opportunity to take a natural break in the passage of the bill – to pause, to listen and to engage with all those who want the NHS to succeed and to subsequently bring forward amendments to improve the plans further in the normal way.'

North Norfolk MP Norman Lamb, who was previously the Lib Dems' health spokesman, said it was right the government took the time to think through the reforms and look carefully at the concerns being raised. 'The Liberal Democrat conference made it clear, through the motions that were passed, that they had a number of serious concerns about various aspects of the package,' Mr Lamb said. 'I think it's fair to say those concerns are shared by others outside of the political arena.

'We said at the time we would listen and take back those concerns, and discussions are ongoing. This is such an important issue that we need to put politics aside.'

Dr Chris Francis, chairman of the Norwich Health Commissioning Consortium, said: 'Whatever our individual feelings about the NHS reforms, myself and other GPs are getting on with setting up GP commissioning consortia in Norfolk, and Norwich has had its selection/election process completed to form a transitional executive – and not exclusively all GPs.

'My hope and belief is that, with the PCTs, we will get on and show clinical leadership of commissioning over the next two years of difficult finances and structural change to look after our patients' best interests and deliver quality healthcare and better health outcomes with reduced inequalities, but many of us would wish to do that anyway regardless of which structure or organisation we work within.'

COMMENT – Page 16.


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