GPs face finance test for NHS powers

Liberal Democrats insist on rigorous checks as MPs debate Andrew Lansley’s NHS bill The Treasury will only support GP-led consortiums if the new bodies have passed rigorous clinical and financial tests, the chancellor’s deputy said on Monday. In a sign of the Lib Dems’ determination to introduce major changes to the health and social care bill, Danny Alexander, the chief secretary to the Treasury and No 2 to George Osborne, told the Guardian the reforms would be implemented in a “variable pattern”. Tory MPs were angered over the weekend when Nick Clegg described the bill as a “disruptive revolution” and said it would be wrong to force GPs to join the new consortiums by 2013. The deputy prime minister felt free to speak so strongly after reaching agreement with Cameron over relaxing the 2013 deadline. Alexander expanded on Clegg’s remarks by suggesting there would never be a uniform imposition of the NHS reforms. He told the Guardian: “We need to be sure that we only allow GP consortia to go forward where they show they are capable and have got all the right building blocks in place so some will go faster than others and we will have a more variable pattern. “From a Treasury point of view, consortia only get the permission to go forward when they are capable clinically and financially to go forward. If GP consortia don’t want to go forward, they will hardly develop the capabilities they need. So we are working very hard on timetables and flexibility right now.” But Alexander makes clear that he hopes the NHS reforms are not abandoned. “Reform is necessary to ensure the NHS is able to deal with these rising health pressures and I just don’t believe the Labour top-down model of the NHS is suitable. So we should not abandon reform. “But at the end of the day if we think this is a bad bill then having no bill would be better than that so we have to come up to substantial changes. What we have heard in recent weeks and months is growing voices in the NHS that there are new things we need to look at.” Alexander opened up a new area of controversy by saying he did not want the new pubic services reform white paper to impose a universal blueprint for reform across the pubic sector. Cameron said in February a presumption would be written into legislation that public services will be delivered by the private or voluntary sectors. Alexander’s intervention came as the Tory whips orchestrated an ostentatious show of support for health secretary Andrew Lansley. Nine cabinet ministers sat with him on the frontbench as he took part in a Commons debate called by Labour. No voting member of the cabinet sat on the frontbench last month when Lansley announced the pause in the health and social care bill that would hand about 60% of the NHS budget to new GP-led consortiums. Lansley told MPs that the changes to the health and social care bill, which will be introduced at the end of the government’s “listening exercise”, would be substantive. He indicated that the consortiums would be expanded to include patients, doctors and nurses. Senior Tories made clear there was growing support for Lansley. One ministerial source said: “David Cameron needs to be careful. Andrew is a lot stronger than he thinks. If Andrew tells the prime minister that he is putting his job at his disposal because Downing Street has undermined his credibility that would make David look foolish.” The Labour motion failed by 284 votes to 231. But Lib Dem MPs expressed anger. Andrew George, the MP for St Ives, called for ministers to “take the guts” out of the reforms because opening the health service to greater free market competition “undermines the NHS ethos”. John Pugh, MP for Southport, said: “I have this vision of a bill being drafted during the daytime by a sane, pragmatic Dr Jekyll-like minister, but during the night some … Mr Hyde jumps in with a rightwing ideology, breaks into Richmond House [the Department of Health] and changes many of the sentences.” The findings will alarm the many medical organisations which have voiced alarm that Lansley’s plans would lead to the NHS undergoing privatisation, a fear that has caused severe unease in Downing Street. Leading cancer charities warn that care received by the growing number of people in England developing the disease could suffer as a result of the government’s NHS plans. Cancer networks, groups of specialists who advise GPs where patients can get the best treatment, are due to be phased out in 2012. But Lansley is resisting calls to keep funding them. Ciaran Devane, chief executive of Macmillan Cancer Support, said: “It’s a deeply worrying prospect that the care of cancer patients could be compromised by this. Cancer patients need to know their care will not suffer.” Health policy Health Danny Alexander Liberal-Conservative coalition Liberal Democrats Conservatives Andrew Lansley NHS Patrick Wintour Nicholas Watt Denis Campbell guardian.co.uk

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