The prime minister has revealed “four Fs” which he believes sum up the government’s approach to the NHS. They came while he attempted to bat off criticism of the Health Bill at a Downing Street summit yesterday.
David Cameron also told attendees he recognised the “need to get the narrative right” to win support for its NHS reforms and said the meeting had demonstrated there was a “need to have a focus on integrated care [and a] need to confront the fears and uncertainty [about the reforms]”.
The prime minister said “four Fs” could sum up the government’s approach to the NHS. The first was its “commitment to the founding principles of the NHS”; the second its “commitment to funding” real terms increases every year; the third its “commitment to making it fit for the future”, a reference to the reforms; and the fourth was a commitment to “freedom for local decision making”.
The meeting – revealed by Nursing Times’ sister title HSJ on Friday – was attended by a number national health representative organisations. Also attending were health secretary Andrew Lansley, former Labour health minister Lord Ara Darzi, NHS chief executive Sir David Nicholson, and Department of Health permanent secretary Una O’Brien.
The event has attracted criticism because the groups most critical of the bill - including the royal colleges of GPs, nursing and midwifery - were not invited.
Mr Lansley was confronted by protestors in Whitehall as he entered the meeting, and attendees were encouraged to leave by a different entrance.
It is understood David Cameron told the meeting he believed the bill would pass through Parliament in the next two months, and he wanted to discuss implementing it. The meeting was titled “implementation of the reforms”.
However, a series of groups, particularly medical royal colleges and patient organisations, said they wanted to reiterate their concerns about the bill. In particular, sources said, representatives of royal colleges said concern among their members had “hardened in recent weeks and months”.
“There was a lot of rehearsal of the series of reasons why people are uneasy about the bill,” said one source. Attendees told Mr Cameron of continuing “concern, lack of clarity, uncertainty and fear”, according to another attendee.
NHS Confederation chief executive Mike Farrar urged the prime minister to engage NHS staff more widely in implementing the reforms. Following the meeting, he said in a statement: “Whatever parliament now decides, getting the whole NHS and clinical community behind any changes will be vital to their success.
“Clearly, there are rifts that will need to be healed if this is to happen. People outside the meeting at No 10, as well as those inside the room, need to be engaged.”
Lord Darzi is understood to have emphasised the need for NHS reform - particularly in commissioning - but said he was strongly against the “demonisation of management”.
One of the attendees, National Voices chief executive Jeremy Taylor, said he raised concerns about the bill, and called for the government to set out a “plan for integrated care”; for it to address the funding and organisation of social care; and for it to put clearer patient rights in the NHS Constitution.
Foundation Trust Network chief executive Sue Slipman, who attended, said Mr Cameron appeared to have recognised the need to listen to organisations during the “transition phase” of the reforms, and groups had emphasised risk to NHS performance and finance is high.