The government will turn its attention to getting the Health and Social Care Bill through the House of Lords after a Commons vote yesterday passed the heavily amended bill.
The Health and Social Care Bill received its third reading by 316 votes to 251, government majority 65.
Prime minister David Cameron insisted the shake-up would create a “stronger NHS” and improve patient outcomes.
Speaking at Prime Minister’s Questions, he said: “The point of our health reforms is to put doctors in charge, give patients greater choice and heal the divide between health and social care.
“I believe that they will lead to a stronger NHS and better outcomes for patients.”
The reforms have endured a rough ride, with progress on the plans “paused” earlier this year following criticism from health professionals and patients groups.
Following a “listening exercise” the bill was sent back to committee in the Commons for a series of revisions, including giving health professionals other than GPs power over how NHS funds are spent, stronger safeguards against a market free-for-all and scrapping a 2013 deadline for the introduction of new commissioning groups.
But as well as facing opposition from Labour and creating concerns for the unions and medical royal colleges, the plans have also exposed fault lines within the coalition.
Now the bill has cleared the Commons it heads to the Lords, where Lib Dem grandee Baroness Williams is set to play a major role after she said she still has concerns over the influence of the private sector and warned the “battle is far from over”.
Health secretary Andrew Lansley said: “The intensity of debate and the brightness of the spotlight shone upon this bill has made it a better bill than when it was first laid before the House.
“I believe it will set the NHS in England on a path of excellence: empowered patients, clinical leadership and a relentless focus on quality.”
But shadow health secretary John Healey said: “This government and this bill are giving health reform a bad name.”
Unison general secretary Dave Prentis joined health workers, patients and the public in a candlelight vigil outside parliament yesterday evening. The vigil was held to draw attention to what the union described as the “damaging consequences” of the bill, “particularly the removal of the private patient income cap, and the threat of privatisation”.
Meanwhile, the Royal College of Nursing issued a statement reiterating its concerns about the bill, after the prime minister suggested in parliament yesterday that the RCN, along with other organisations, was in support of the legislation.
RCN chief executive and general secretary Peter Carter said: “While we acknowledge that the government have listened to our members in a number of areas, we still have very serious concerns about where these reforms leave a health service already facing an unprecedented financial challenge.
“The government has now changed the bill in response to calls from nurses and others, setting out what will happen if providers fail either financially or clinically, amending the language of Monitor’s role in competition and ensuring that nurses will be represented on the clinical commissioning group boards. We have also welcomed the government’s commitment to maintain a system for professional education and training within the comprehensive health service.
“However, at a time when the NHS needs to find £20bn in efficiencies, tackle waste, work harder to prevent ill health and deal with an aging population, we are telling MPs that this bill risks creating a new and expensive bureaucracy and fragmenting care. This fragmentation risks making inequalities worse, and preventing health providers from collaborating in the interests of patients.
“We must avoid a situation where existing NHS providers are left with expensive areas of care while private providers are able to ‘cherry pick’ the services which can be delivered easily.”