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Cameron not planning to back down on NHS reforms

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The prime minister has restated the case for the government’s NHS reforms and sought to clarify the plans for competition in the NHS.

Speaking at Ealing Hospital in West London today, David Cameron indicated the government is not planning to back down on proposals to allow non NHS providers to compete on a level playing field with the NHS.

He said “any willing provider” had been a misleading name for the policy, but defended the principle of the reform. He said competition would only be extended to include “properly qualified providers”. “It was always meant to be NHS quality at NHS prices,” he said.

In March, ministers began referring to the policy as “any qualified provider”.

Mr Cameron also backed a plan to make private providers pay the proposed levy on NHS providers to fund the training of health professionals. The suggestion was made in the Department of Health’s consultation paper, published last December, Liberating the NHS: Developing the Healthcare Workforce.

The principle appeared to be supported by Monitor chair David Bennett in February while giving evidence to the Commons health committee. Mr Bennett said “an element” of commissioners’ payments to the independent sector could be used to fund training.

Health secretary Andrew Lansley also told a conference last month: “When we talk about a level playing field, we mean a level playing field… we want private providers to be under the same obligations in relation to education and training. No special advantages.”

Mr Cameron today said he would not “pre-empt” the “substantive changes to improve the reforms” expected following the listening exercise. But he said he agreed with some concerns that “we need hospital doctors and nurses to be much more closely engaged in commissioning”.

He said: “There will be choice for patients, not competition for its own sake. Innovation and improvement, not breaking up efficient and integrated care. It will be evolutionary, not revolutionary.

“Our changes are a logical extension of tried-and-tested policies initiated by governments of all parties in recent years. Clinical commissioning has existed in one form or another for the past two decades.

Payment by results, and foundation trusts, for the best part of the past decade. Working with others from the independent sector too – that’s not new either.”

He emphasised the role of clinical commissioning in reforms. He said: “[At present] we have a commissioning process where a tier of management, who sit above doctors, are in charge. Yes, these managers do important and valuable work. But they’re not on the frontline so sometimes they don’t know precisely what local patients need.”

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Readers' comments (1)

  • So much for the vaunted 'listening excercise then eh?

    I find the way they are doing this very worrying. Yes, we all know there are huge problems with the NHS, and we all have been saying for a long time things need to change. HOWEVER, that does not mean that THESE changes are the right ones, that does not mean that the government can ride roughshod over the considered opinions of experts 'on the frontline' such as us just so they can drive through their reforms, especially when Doctors, Nurses and other health professionals alike have said they will not work and will cause a lot more problems in the long run. For example, Cameron is right in the fact that clinicians need to be in charge of the NHS, not a tier of management. But why does 'clinician' for the government simply mean GP?

    Yes there are changes - perhaps some big ones - that need to be made within the NHS, but these are not the right changes, and this is not the way to go about doing them.

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