Clegg casts doubt on NHS reform timetable

Nick Clegg has given the clearest signal yet that the Government does not expect its plans for NHS reform to go ahead on time.

The Deputy Prime Minister told the House of Commons that the flagship policy of replacing Primary Care Trusts with GP-led consortia won’t be enforced if doctors are not ready to take over responsibility for commissioning services by 2013.

The Government had previously said it wanted the controversial consortia to be up and running by April of that year. But Mr Clegg told MPs: “There should be nothing doctrinaire about the point at which GP consortia become the commissioning consortia in the NHS system.”

He added: “That is why there will be very exacting requirements applied to those consortia so that if they are not ready by April 2013 then they will not be given those new commissioning powers.”

Read more: Channel 4 News political editor Gary Gibbon on the political storm faced by Nick Clegg

The future of the Health Secretary Andrew Lansley’s flagship vision of consortia led by GPs taking control of 60 per cent of the NHS’s £103 billion budget has already faced criticism from all sides, including the British Medical Association.

The Labour leader Ed Miliband has called the reforms “extremely dangerous” and unions are opposed to many parts of the Bill, particularly those which promote more competition between the NHS and private companies.

The latest blow to Mr Lansley’s vision came on Tuesday when the former Conservative Health Secretary Stephen Dorrell, now chairman of the Health Select Committee, announced a string of proposed amendments to the legislation.

“We will be looking at these concerns, and will be looking to amend the legislation to reflect that.” Deputy Prime Minister Nick Clegg

The committee wants to scrap the idea of GP-led consortia in favour of local commissioning boards.

GPs will still form the majority of membership, but nurses, hospital doctors, elected members of local councils, social care representatives and public health experts will also be involved.

Mr Dorrell said: “We believe this broadening of the base for commissioning is vital if we are to achieve the changes that are necessary to allow the NHS deliver properly co-ordinated healthcare.”

The committee also wants the name “GP consortia” to be dropped in favour of “NHS Commissioning Authorities”. Each authority should have an independent chairman and should meet in public to ensure accountability, MPs recommend.

The Government has so far taken a conciliatory tone in its response to the recommendations, with Mr Cameron and Clegg to take part in a “listening exercise” this week.

Read more: NHS reform could spell the end of universal healthcare

On Monday, Mr Lansley told MPs: “We propose to take the opportunity of 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 subsequently to bring forward amendments to improve the plans further in the normal way.”

Mr Clegg said it was an “uncontroversial idea” to give GPs more responsibility, saying: “It is a rather good idea to have them in the driving seat, rather than unaccountable officials who are moving money around from one side of the desk to the other.

“But, yes, with responsibility must come more accountability, which is precisely why we will be looking at these concerns, and will be looking to amend the legislation to reflect that.”

The Liberal Democrat leader said the Government would listen to “legitimate” concerns about the Bill, and there could be “substantial” changes to the legislation.

He added: “The NHS is not the Government’s property. We want people to feel comfortable with the changes, which will strengthen, and not weaken, the NHS.”

Mr Clegg will join Mr Lansley and David Cameron later this week for a joint announcement on the scale of amendments that have been made to the legislation in light of the Select Committee’s report.

Union opposition

Members of the trade union Unison pledged to defeat the bill at their annual health workers conference in Liverpool.

General Secretary Dave Prentis told the 1,000 delegates that Ministers had “thrown a grenade” into the middle of healthcare. He said: “We cannot rest until the guts are ripped out of this Bill. Andrew Lansley talks about a natural pause, well I say – keep your dirty paws to yourself and keep your dirty paws off our health service.

“He says he wants to liberate health workers – sounds a bit like George Bush when he said he wanted to liberate Iraq.”

A Unison spokesman said she feared the Government would try to use the consultation period to try to save the legislation by chipping away at objections raised separately by various unions and professional bodies. She told Channel 4 News: “I think what they will try to do is to divide and rule – pick people off one by one and make small concessions.

“Our position is that it’s not just the timetable that is unrealistic. The whole Healthcare Bill is unrealistic.”

Read more - Special reports: NHS uncovered