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| Version 0 | Version 1 |
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| NHS overhaul: What next? | NHS overhaul: What next? |
| (about 3 hours later) | |
| By Nick Triggle Health correspondent, BBC News | By Nick Triggle Health correspondent, BBC News |
| The NHS listening exercise is drawing to a close, but still the criticisms keep coming. | The NHS listening exercise is drawing to a close, but still the criticisms keep coming. |
| The British Medical Association has now weighed in, suggesting the health bill for England may even need to be withdrawn. | The British Medical Association has now weighed in, suggesting the health bill for England may even need to be withdrawn. |
| This is despite the government spending the last six weeks trying to get critics on board. | This is despite the government spending the last six weeks trying to get critics on board. |
| More than 200 listening events have been held with thousands of doctors, nurses and patients. | More than 200 listening events have been held with thousands of doctors, nurses and patients. |
| Health Secretary Andrew Lansley has himself been to 30 - about one for every working day. | Health Secretary Andrew Lansley has himself been to 30 - about one for every working day. |
| He has been joined by both the prime minister and deputy prime minister at times. | He has been joined by both the prime minister and deputy prime minister at times. |
| Submissions have also been made via the internet, while leading organisations have written to David Cameron personally. | Submissions have also been made via the internet, while leading organisations have written to David Cameron personally. |
| So what now? | So what now? |
class="section-header" id="heading-1">Write the report | |
| Officially, the government is saying no decisions will be made until the report of the NHS Future Forum, the group which led the listening exercise, is in. | Officially, the government is saying no decisions will be made until the report of the NHS Future Forum, the group which led the listening exercise, is in. |
| The forum has been chaired by Professor Steve Field, the former leader of the Royal College of GPs. | The forum has been chaired by Professor Steve Field, the former leader of the Royal College of GPs. |
| He will spend the next week or so writing his report after the completion of the final listening events over the next few days. It is expected to make a wide range of recommendations about how the plans need to be altered. | He will spend the next week or so writing his report after the completion of the final listening events over the next few days. It is expected to make a wide range of recommendations about how the plans need to be altered. |
| Professor Field has already made it clear greater clarification is needed over the issue of competition. Under the current proposals, there is a duty on the economic regulator, Monitor, to promote competition. | Professor Field has already made it clear greater clarification is needed over the issue of competition. Under the current proposals, there is a duty on the economic regulator, Monitor, to promote competition. |
| Whether this goes completely - as some critics have called for - remains to be seen, but there is likely at least to be a change in tone with more emphasis placed on collaboration between the NHS, private sector and charities. | Whether this goes completely - as some critics have called for - remains to be seen, but there is likely at least to be a change in tone with more emphasis placed on collaboration between the NHS, private sector and charities. |
| Professor Field is also known to be looking at whether primary care trusts - the management bodies Mr Lansley wants to scrap - should stay on in some form to support GP consortia. | Professor Field is also known to be looking at whether primary care trusts - the management bodies Mr Lansley wants to scrap - should stay on in some form to support GP consortia. |
id="heading-1">Smooth | id="heading-2">Smoothover the tensions |
| A combination of poor election results and the fall-out from the tuition fees row has meant the Lib Dems have come out fighting on the NHS. | A combination of poor election results and the fall-out from the tuition fees row has meant the Lib Dems have come out fighting on the NHS. |
| Nick Clegg has made it clear he wants to see changes, particularly to the role of Monitor. | Nick Clegg has made it clear he wants to see changes, particularly to the role of Monitor. |
| His positioning has meant clear divisions have begun to open up in the coalition for arguably the first time. | His positioning has meant clear divisions have begun to open up in the coalition for arguably the first time. |
| He has talked about being a moderating influence in the government, much to the annoyance of many in the Tory party. | He has talked about being a moderating influence in the government, much to the annoyance of many in the Tory party. |
| In many ways, the listening event has changed the nature of the coalition - and both parties need to adjust to that. And quickly. | In many ways, the listening event has changed the nature of the coalition - and both parties need to adjust to that. And quickly. |
id="heading-2">Get | id="heading-3">Getthe profession on side |
| Mr Lansley faced perhaps his more difficult day of the last two months when he visited the Royal College of Nursing conference in Liverpool before Easter. | Mr Lansley faced perhaps his more difficult day of the last two months when he visited the Royal College of Nursing conference in Liverpool before Easter. |
| On the morning of his visit delegates gave him a vote of no confidence. He then faced a meeting of more than 60 nurses amid claims he was running scared of the full conference hall. | On the morning of his visit delegates gave him a vote of no confidence. He then faced a meeting of more than 60 nurses amid claims he was running scared of the full conference hall. |
| And, of course, the BMA has now set out its concerns. | And, of course, the BMA has now set out its concerns. |
| Without warmer words from groups such as the BMA and RCN in the coming months, it will be difficult for the government to get the reforms back on track. | Without warmer words from groups such as the BMA and RCN in the coming months, it will be difficult for the government to get the reforms back on track. |
| It seems whatever concessions are made need to answer their criticisms. | It seems whatever concessions are made need to answer their criticisms. |
id="heading-3">Produce | id="heading-4">Producea coherent set of proposals |
| With so many vested interests, those on the front-line in the NHS have begun to voice fears the pause could lead to a series of cobbled together, contradictory concessions. | With so many vested interests, those on the front-line in the NHS have begun to voice fears the pause could lead to a series of cobbled together, contradictory concessions. |
| This would be the worst outcome. Almost all those involved in the NHS believe change is necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes, such as obesity. | This would be the worst outcome. Almost all those involved in the NHS believe change is necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes, such as obesity. |
| If there is not a clear vision for the future, the NHS could find itself struggling to just maintain standards never mind improve them. | If there is not a clear vision for the future, the NHS could find itself struggling to just maintain standards never mind improve them. |
| Officials have already talked about giving themselves a few weeks once Professor Field has submitted his report before announcing what concessions will be made. | Officials have already talked about giving themselves a few weeks once Professor Field has submitted his report before announcing what concessions will be made. |
| The prime minister, deputy prime minister and health secretary have all talked about substantial changes. | The prime minister, deputy prime minister and health secretary have all talked about substantial changes. |
| The challenge is making them in a coordinated way that convinces those working in the NHS and the public that relies on it that the government has got it right this time. It promises to be a tricky balancing act. | The challenge is making them in a coordinated way that convinces those working in the NHS and the public that relies on it that the government has got it right this time. It promises to be a tricky balancing act. |