Government to press ahead with radical NHS reform plans

Health Secretary Andrew Lansley said a ''very large'' number of people are ''happy'' about change

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The government has confirmed it is to push ahead with big structural changes to the NHS in England.

Health Secretary Andrew Lansley said the reform agenda was "on track" following a public consultation, despite concerns from health unions.

Primary Care Trusts are to be abolished by 2013, when GPs will plan hospital care and manage budgets to pay for it.

Shadow health secretary John Healey said it was the wrong time to be making such big changes to the health service.

He said: "This is a massive upheaval and a massive distraction and it puts a pressure on the NHS which it could live without at the moment.

"And when the doctors don't want it, the health experts are warning against it, patients groups are concerned, this is really the last thing that the government needs to do."

Operating framework

The Department of Health has carried out a public consultation on reform plans set out in a White Paper, receiving some 6,000 responses.

Analysis

Within the health service PCTs have seen their budgets increase by £2.6bn to £89bn, a figure that stays just above the government's own measure of inflation.

But this isn't extra money available to the NHS as a whole - that budget is fixed. Instead the extra cash is likely to have come from a squeeze on the finances of hospitals.

Payments for treatments, known as the tariff, have been frozen, and hospitals find themselves at the sharp end of finding savings in the NHS.

Pressure will grow to move some types of care out of hospitals and into the community.

And none of this changes the need for the health service in England to find efficiency savings of £20bn over the next few years, a task the Health Select Committee says will test the NHS to the limit.

It has also published its "operating framework" for the NHS, setting out priorities for the next financial year, including allocation of money to PCTs, ahead of their eventual abolition.

Mr Lansley said £89bn would go to PCTs for frontline services.

And he told members of the Health Select Committee: "And of course in addition to that, there is a great deal of scope - and necessity - for the generation of savings through improved productivity and efficiency and quality gain inside every part of the service, which will enable us next year, I hope, not only to meet demands but to improve the service we offer."

PCTs are local organisations which control 80% of the NHS budget and are responsible for providing services such as hospitals, dentists and opticians.

All 151 in England are set to be scrapped, along with the next tier of organisation, the Strategic Health Authorities - 10 of which operate at a regional level.

In future, the bulk of the NHS budget will be allocated to GPs working in consortia across the country.

Around 50 GP consortia have signed up as "pathfinders" to manage their local budgets and commission services for patients.

Mixed-sex wards

Earlier, Mr Lansley told the BBC that, from next April, hospitals would be "held to account" if they failed to get rid of mixed-sex wards.

"We are not going to pay hospitals for providing a sub-standard service," he said.

"Patients have a right to expect dignity and privacy and if there is a breach of that, that will be published."

The NHS in England faces increasing financial pressures, not least the need to make up to £20bn in efficiency savings over the next four years.

On Tuesday, the Commons Health Select Committee said meeting that target would test the NHS to the limit.

The reforms do not affect the health services in Scotland, Wales and Northern Ireland, which are devolved to their national administrations.

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