Analysis: Is there light at the end of the NHS tunnel?

A doctor The government has faced criticism from unions, medical experts, academics and MPs

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It has got to the stage where people are queuing up to have a go at the government's health reforms in England.

Unions such as the British Medical Association and Royal College of Nursing have been at the front of the queue.

But in recent weeks they have been joined by some of the medical royal colleges, professional bodies who set standards in areas such as training and education and, as such, tend to be less political.

Independent experts, including a former NHS chief executive, have also entered the fray.

And then, over the weekend, Lib Dem members once again made it clear that they were not in favour after voting against the changes at their spring conference.

All in all, it has created a toxic atmosphere. But despite this there is light at the end of the tunnel.

A lack of winter blues

For the NHS, bad weather means one thing - more patients. Research shows that cold spells lead to more accidents and increasing admissions for everything from respiratory disease to stroke.

Coupled to this is the spike in seasonal flu cases that are normally seen in the early months of the year.

But this winter has been mild. Apart from the cold snap in the first half of February the weather has been relatively warm.

And the ripple effect has been felt in the NHS.

Without the pressure of lots of extra patients, touchstone issues such as waiting times and A&E queues have been kept in check.

This has allowed the debate and arguments about the reforms to take place on a largely theoretical level - a much easier scenario to deal than having a row to a backdrop of images of suffering patients.

The show has gone on

While ministers have spent the best part of the year defending their reforms, on the ground the revolution has been quietly gathering pace.

Nearly 250 GP-led groups have been set up across 97% of the country to take control of the NHS budget from April next year.

The national board which will oversee the new system already has a chief executive and should have a nine-strong senior management team in place within months.

It means the building blocks are in place despite the slow progress of the bill through Parliament.

And it has meant ministers have been able to be patient - even with the intense pressure being applied - safe in the knowledge the NHS will almost certainly be ready to go if and when the bill is passed.

Lords have not been leaping

Parliamentary progress has been slow. The bill was first introduced in January 2011 and ministers were hopeful it would complete its passage within the year.

In the end, it came nowhere near. Instead, early summer 2012 is now a more realistic date.

But despite the Lords going through the bill with a fine toothcomb, leading to countless amendments being tabled by ministers. There has only been one defeat - much less than the government suffered over welfare reform.

Even the most contentious parts covering competition were voted through last week.

It means the bill is set to return to the House of Commons and is now likely to complete its passage in the next few months.

A summer of fun

Health is not the only government department looking forward to the feel good factor of hosting the Olympics kicking in.

A successful Games will divert attention from the troubles with the NHS reform as well as the many battles the coalition is fighting on issues such as the economy, education and welfare.

By the time the Olympics gets under way the bill could have completed all its Parliamentary hurdles and with the country basking in the the 'Greatest Show on Earth' the battles of the past 18 months could be a distant memory.

After all, this is not the first time a government has had to battle against the medical profession and MPs to achieve health reform.

Nine years ago, the Labour government had to fight hard to get its legislation on foundation trusts through. Now they are widely accepted as a natural part of the health service.

Even the creation of the NHS in the aftermath of World War II was not an easy ride. The then health minister, Aneurin Bevan, famously said he had to stuff the mouths of doctors with gold to get them on-board.

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