Cameron 'at one' with Lansley over NHS changes

Hospital ward The bill is one of the flagship pieces of legislation from the Conservative-Lib Dem coalition government

David Cameron has said he is "at one" with Andrew Lansley amid speculation about the health secretary's position and the controversial NHS bill.

Writing in the Sunday Times, the prime minister said there was no alternative to changes going through Parliament.

His intervention follows reports three Conservative cabinet ministers privately attacked Mr Lansley's handing of the bill, which applies to England.

The changes give GPs control of much of their budgets and widen competition.

While giving GPs a bigger say has been quite widely welcomed among health unions and NHS organisations, the competition element remains deeply controversial.

Mr Cameron said he strongly supported the founding principles of the NHS, including "health care for all, free at the point of use, unrelated to the ability to pay".

But he added: "While the values are right, the system isn't. It needs to change - and that is why I am at one with Andrew Lansley, the reform programme and the legislation going through Parliament."

The Health and Social Care Bill introduces the biggest shake-up since the founding of the NHS in 1948, putting GPs in control of much of its budget and encouraging greater competition with the private sector.

A controversial bill

  • The Health and Social Care Bill is one of the flagship pieces of legislation from the Conservative-Lib Dem coalition government
  • GPs and other clinicians are to be given much more responsibility for NHS spending in England and greater competition with the private sector encouraged
  • The plans were put on hold last spring after opposition from MPs and peers. Labour warned of privatisation at the expense of patient care.
  • After a "listening exercise" some changes were made and the revised bill cleared its next Commons stage
  • But when the bill was in the Lords before Christmas it faced mounting opposition and the royal colleges of nurses and midwives joined those who opposed the bill outright.
  • Labour are calling for the bill to be dropped, but a series of fresh amendments have been put forward aimed at tackling critics' concerns.

Mr Cameron said the bill empowered doctors and nurses and would lead to more choice for patients and competition for treatment.

"Choice, competition and transparency may unsettle some people," he wrote.

"But it's these things at the heart of our reform that will lead to the better NHS I care about and our country deserves."

He said the government would provide an extra £12.5bn during this parliament to eradicate health inequalities and help with cost pressures.

The £4.5bn savings the reforms offered would be reinvested into patient care, he added.

Mr Lansley has denied he has lost support from within his own party, and has insisted Tories were "working together".

Asked on Friday if he would resign to get the bill through, he said: "No... we as a government are committed to supporting the NHS.

"This legislation has been supported by the House of Commons, supported by the House of Lords. The bill has been amended to take account of many changes."

There are reports that one minister compared the scale of the bill's problems to those surrounding the Poll Tax in the 1980s.

And Mr Cameron's office has denied a newspaper report that quoted an unnamed Downing Street source as saying Mr Lansley should be "taken out and shot".

Mr Cameron also attacked Labour's "opportunism" over the issue and said the reforms were an "evolution" from proposals introduced by the previous government.

"Modest spending increases without reform will not work," he wrote.

Vanity projects

"The failings of the current set-up are too profound and the future pressures are too great. But I want to reassure people that the change we propose is evolutionary, not revolutionary.

"Because while Labour wasted money on bureaucracy and vanity projects like the NHS Super Computer, and while top-down targets distorted some clinical priorities, there was the start of sensible reform."

Labour leader Ed Miliband has called on the prime minister to drop the NHS bill, which he says is wasting billions of pounds on a bureaucratic re-organisation and threatens a "creeping privatisation of the National Health Service".

He says NHS staff are opposed to the bill and have told the prime minister so, as are members of Mr Cameron's own cabinet.

The British Medical Association and the Royal College of Nursing are amongst medical professional groups to also oppose the bill.

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