Tory MPs concerned that prime minister has abandoned key elements of Andrew Lansley’s radical NHS blueprint David Cameron is facing a battle to reassure anxious Conservative MPs after he announced a series of changes to the government’s NHS reforms to win over the Liberal Democrats and members of the medical profession. As Nick Clegg told his parliamentary party last night that the time was fast approaching for the Liberal Democrats to swing behind the reforms after securing major concessions, Tories voiced concerns that the prime minister had abandoned key elements of Andrew Lansley’s original blueprint. Cameron alarmed his backbenchers after he moved to meet the demands laid down by the Lib Dems at their spring conference in March by announcing the shelving of Lansley’s 2013 deadline, changes to the role of the health regulator, Monitor, and the opening up of GP-led consortiums. A senior Tory MP who warned last month that core “red lines” must not be crossed, warned shelving the 2013 deadline could threaten £5bn of spending on frontline health services. Nick de Bois, who was involved in the committee stage of the health and social care bill, said: “It would be a mistake to lose 2013 as a statutory date for completion of countrywide GP commissioning. “Yes, we will need to help GP commissioners get there. But if we don’t achieve that date we could end up with a two-tier health system much as we had under GP fund holding, and we could threaten the potential £5bn savings over the lifetime of this parliament to put back into frontline services.” The backbencher spoke out after Cameron outlined four key changes to the NHS reforms. In a speech to members of the medical profession at the clinical neurological centre at University College London Hospital, the prime minister said: • The health and social care bill will be amended to make clear that the primary role of Monitor is not to promote competition but to promote the interests of patients. It will “use competition as a means to that end”. • The 2013 deadline for the creation of new GP-led commissioning consortiums, due to take charge of 65% of the NHS budget, will be shelved. • Clinical commissioning will be opened up, with hospital doctors and nurses involved. Clinical senates will be introduced to allow groups of doctors and healthcare professionals to “take an overview of the integration of care” across a wide area. In a key declaration, Cameron said: “Our changes will now secure clinically led commissioning, not just GP-led commissioning.” • The 18-week limit on waiting times, enshrined in the NHS constitution, will be kept. Lady Williams of Crosby, the former member of the Gang of Four who has been one of the main Lib Dem rebels, welcomed the changes: “What we are now seeing, partly owing to tremendous efforts on the part of my own party, not least Nick Clegg, is a real change in the shape of what is going to be proposed. I think we will see really very substantial changes.” NHS David Cameron Conservatives Andrew Lansley Health Liberal Democrats Nicholas Watt guardian.co.uk