The government has handed maternity to GP commissioning consortia and given councils formal scrutiny powers to cover NHS funded services in changes outlined in its response to the white paper consultation.
The government published its response to its white paper on the NHS on Wednesday morning, setting out how it will take the reforms forward, and paving the way for the introduction of a “flagship” bill in the New Year.
The Department of Health said Liberating the NHS: Legislative Framework and Next Steps document outlines how ministers have “developed their thinking” after receiving 6,000 responses to the white paper consultation.
Among the changes from the original white paper are that the commissioning of maternity services will now sit with GP consortia, rather than the NHS commissioning board, and that councils’ formal scrutiny powers will be extended to cover all NHS-funded services, and local authorities will have greater freedom in how these are exercised.
Cllr David Rogers (Lib Dem), chair of the Local Government Association’s community wellbeing board, said the announcement reflected many of the LGA’s proposals.
“The LGA has consistently stressed that key to the shake-up’s success is local leadership and accountability. We called for the new Health and Wellbeing Boards to be given teeth and put on a statutory footing, and this has happened,” he said.
“We fought hard against plans to scrap separate health overview and scrutiny committees, and our arguments have hit home. Extending formal council scrutiny to cover all NHS-funded services is a positive move, as is the decision to give health and wellbeing boards powers to make sure NHS commissioners work together with town halls to improve the health of their communities.
“Our members were also concerned the new system may not be truly ready before the abolition of primary care trusts in 2013. That our calls to speed up the introduction of wellbeing boards and phase in new GP consortia with pilot schemes have been acted on is reassuring. And the move to make GP commissioning decisions more transparent can only be a good thing.”
Health secretary Andrew Lansley said the response document “answers the questions and sets the framework for reform”.
He said: “We have listened extensively to all views about our health reforms. And now, with thanks to some 6,000 responses, we are publishing a paper that sets out with clarity and with direction why and how we need to deliver long-lasting reform in the NHS.
“Our reform agenda is on track,” he said.
Mr Lansley added: “The health and social care bill will be presented early in the New Year. Its purpose is clear: a more responsive, patient-centred NHS, which achieves outcomes that are among the best in the world. It provides certainty, through a clear legislative framework to support that ambition, with increased autonomy and accountability at every level in the NHS.”
However, despite the upbeat nature of these comments, Mr Lansley and minister Paul Burstow warn in the foreword to the response document that productivity and outcomes must improve against the background of tough economic times.
They write: “Put simply, for all the efforts and endeavours of frontline staff, outcomes for patients still lag behind the best healthcare systems internationally. In addition, productivity in the NHS has declined in the recent years. Through the coming years, every part of the NHS needs to make every penny count for patients.
“The energy and enthusiasm on the frontline to make these reforms happen demonstrate that we were right to embark on this journey. One-quarter of the country is already covered by ‘pathfinder’ GP consortia.”
They add: “By next year, we expect 25,000 staff – delivering some £900m of NHS community services – to be doing so as members of social enterprises. The further development of NHS foundation trusts is proceeding at pace.”