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NHS overhaul: What next? | NHS overhaul: What next? |
(12 days 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. |
Despite David Cameron's insistence that there will be "real changes" to the proposed reforms for the NHS in England, doctors' leaders doubt it. | |
The British Medical Association's chairman says the Prime Minister's renewed pledges are "not a game-changer". | |
The government has spent the last two months trying to get critics on board. | |
After more than 200 listening events with thousands of doctors, nurses and patients, the consultation is now ready for publication next week. | |
Mr Cameron has said he will support a number of important changes to the proposals, including more say for hospital doctors and nurses and limits on competition. | |
So, what next? | |
class="section-header" id="heading-1">The changes | |
| 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 published. |
But Mr Cameron has outlined a few key changes in the meantime: | |
| |
The detail will not come until next week. But it is expected to make a wide range of recommendations about how the plans need to be altered. | |
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. |
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. |
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. |
Smooth over the tensions | Smooth over 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. |
Get the profession on side | Get the profession on side |
It seems whatever concessions are made need to answer the criticisms of the NHS staff, who will be the ones working in the new system. | |
Mr Lansley faced perhaps his more difficult day of the past 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 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. |
Produce a coherent set of proposals | Produce a coherent set of proposals |
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. |
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 health service 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 health service and the public that relies on it that the government has got it right this time. It promises to be a tricky balancing act. |