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Jun 14th, 2011

NHS: What did Cameron and Clegg’s speeches today mean?

By 38 Degrees team

David Cameron and Nick Clegg admitted today that the original NHS plans were wrong, and accepted the need for changes which are quite helpfully summarised by the Guardian here. We’ve not won yet – but we definitely have made progress. According to Andrew Lansley’s original timetable, the NHS changes would be law by now. We’ve helped stop that happen.

Back in April thousands of us voted to decide which parts of the NHS plans we were most worried about and so should focus our campaign on. Here’s an early attempt to assess what Cameron in Clegg speeches today might mean for those areas of concern which we prioritised. This all comes with a huge disclaimer: it’s a hurried start which will improve with feedback from more 38 Degrees members.

Additionally, what we heard today was just a couple of speeches – we haven’t seen the full text of the proposed laws. We will need to go through the new plans line by line and be ready to challenge them wherever needed.

So, please help by adding your thoughts and analysis as comments below.

What we decided together to focus on What David Cameron’s new proposals might mean
Don’t force the NHS to promote
competition between private health companies: rule out price competition and promote co-operation and quality of care instead
Some Progress.
It sounds like the role of the NHS regulator, “Monitor”, will now have an overall focus on promoting the interests of patients not price competition as originally proposed. 

The devil will be in the detail of how this works, and there is probably still more talk of competition than lots of us would like. Lib Dem MP Andrew George has warned “Monitor” could act as a “trojan horse” allowing more of the original plans to be slipped “through the back door”.

Don’t allow private companies to “cherry pick” healthcare contracts in a way which could undermine local hospitals: put NHS services and hospitals first Some progress.
There will be “new safeguards” to stop private companies taking over the job of commissioning health services where hard-pressed GPs are unwilling. But the government wants to keep the policy of “Any Willing Provider” being allowed to run NHS services, including private companies.  Many experts say this policy means that in practice it will be extremely difficult to prevent “cherry-picking”. We will definitely need to look hard at this area of the legislation when it is published.
Don’t take big decisions about
health spending without experts and patients being involved as well as GPs
A lot of progress.
It sounds like patients, nurses, and hospital doctors will now be involved in taking decisions as well as GPs. Mental Health Charity Rethink is describing the revised plans as “a real step forward for patient power”.
Don’t allow big decisions about
health spending be taken behind closed doors and without democratic scrutiny
Some Progress.
It seems that local “health and well-being boards”, which include elected local people, will have a beefed up role in scrutinising what GP commissioning boards are up to.
Don’t force any big changes
without testing them properly first – trial any changes in one area for several years first, then give parliament a fresh vote
A little bit of progress.
The timetable for imposing the changes has definitely been slowed down, with many of the original deadlines dropped or softened. But the
government still isn’t proposing a local trial, or a fresh vote once we’ve seen how all of the new systems work.
Don’t remove the government’s
“duty” to provide a comprehensive health service: keep that duty in law
It’s being reported that the Bill will be rewritten to reinstate this comprehensive duty. That would be a massive success – but we need to see it happen in practice before we can relax!
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