NHS: The shape of things to come
The health and social care bill has gone though more than a year of debate and more than 1,000 amendments in the Commons and the Lords. So what has changed?
What the coalition wanted:
* GPs to take responsibility for £60bn of NHS funds
* Competition to be extended to more NHS services
* Reduced bureaucracy and fewer managers
* An increased role for the private sector
* Backing from every professional group involved.
What they have had to compromise on:
* NHS professionals such as hospital consultants and nurses given greater say in spending
* Competition limited to quality not price
* More managers to look into perceived risks
* All providers to be assessed for their suitability to run services.
The shape of things to come:
* Clinical commissioning groups (CCGs) replace primary care trusts
* CCGs decide on care for patients, advise them where to go for treatment and pay the bills
*Some of the day-to-day control of the NHS passes to the new NHS Commissioning Board, which will manage the CCGs at a national and local level
*Responsibility for public health issues like obesity, smoking and alcohol abuse is handed to local councils
*All hospitals become foundation trusts and compete for treatment contracts from CCGs
*The cap on how much hospitals can earn from private patients rises from as little as 1.5% to 49%.