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Health secretary, under pressure over plans outlined in NHS bill, says he accepts case for rethink on certain elements The health secretary, Andrew Lansley, has indicated that he is ready to accept “substantial and significant changes” to his health reforms, but warned that the status quo is “not an option”. Lansley – who has been under increasing pressure over the reform plans outlined in the health and social care bill – said he accepted the case for a rethink on certain elements “if they help us improve care for patients”. But in comments that appeared designed to scotch speculation that he is set to either quit or be sacked over his handling of the reforms, Lansley outlined the case for changes that would make the NHS work better and “smarter” and deliver better outcomes for patients by putting them “firmly in the seat”. The bill outlines plans to abolish primary care trusts and strategic health authorities and allow GP-led consortiums to decide to buy treatment either from public or private providers. The health secretary’s first remarks since the end of the government’s listening exercise on the plans, which was ordered by David Cameron two months ago, coincided with a warning from the leading doctors’ union about a “completely unethical” measure outlined in the bill. The British Medical Association urged the government to remove plans to introduce performance-related bonuses because that could undermine patient trust. Dr Laurence Buckman, the chairman of the BMA’s GPs committee, said the trust patients put in their doctor is the “cornerstone” of general practice. “Financially rewarding GPs by directly linking their earnings to their consortium’s financial management, particularly when the NHS is under continuing pressure to reduce budgets, is completely unethical. “GPs are very concerned about the potential conflicts of interest inherent in the health bill.” The latest intervention shows the pressure Lansley will be under to amend his reforms following the publication of the NHS Future Forum report following the listening exercise. In an article in the Daily Telegraph, Lansley sought to allay fears that the plans would lead to privatisation, but said sticking with the status quo was “not an option” because of the twin pressures of an ageing population and rising treatment cost which “paint a compelling picture of why we have to modernise our health service and make it sustainable for the long term”. A failure to act now would “almost certainly mean a crisis tomorrow” which could threaten the NHS as a comprehensive and universal service free at the point of use. “I will not allow that to happen,” he wrote. “We will never privatise our NHS. But if we choose to ignore the pressures on it, the health service will face a financial crisis within a matter of years that will threaten the very values we hold so dear – of a comprehensive health service, available to all, free at the point of use and based on need and not the ability to pay.” The Labour MP John Healey MP accused Lansley of “adding to confusion and uncertainty in the health service” with the Telegraph article. “He makes a case for change, but not the Tory-led government’s top-down reorganisation of the NHS,” Healey said. “As Labour has argued from the outset and, as the chorus of criticism during the ‘pause’ [listening exercise] has underlined, these are the wrong reforms for the NHS. They are being forced through for reasons of political ideology not improved patient care. “The huge upheaval of reorganisation is making it harder, not easier, for the NHS to deal with the financial and efficiency squeeze.” Health policy Andrew Lansley Health NHS GPs Public services policy Doctors Hélène Mulholland guardian.co.uk