NHS bill to be delayed further

The prime minister is convinced that changes to the NHS are needed

Planned cuts to NHS budgets in England may be delayed while MPs sort out the government’s controversial health reforms, the BBC understands.

PM David Cameron “paused” the reforms aimed at handing control of budgets to GPs and increasing competition.

But the scale of changes demanded by health professionals when the listening exercise reports back could delay the passage of the bill even further.

MPs may be forced back to the drawing board on key elements of it.

The BBC understands the Health and Social Care Bill may have to be “recommitted” – a rare procedure which would see its committee stage being repeated.

The prospect of redoing part of the Parliamentary passage of the bill has been actively discussed but not finally settled, it is believed.

That could mean delays to the timetable of reforms scheduled for 2012 and potentially risk the billions of pounds of savings that have to be made by the NHS by 2014.

The question politically is whether the changes will be radical enough to satisfy Deputy Prime Minister Nick Clegg and the Liberal Democrats without losing the substance of Health Secretary Andrew Lansley’s original plans.

Number 10 has already said the reforms must continue.

All will become clearer when the government gives its response to the NHS Future Forum – expected in the middle of next month.

The Future Forum, made up of 45 clinicians, patient representatives and health staff, will hold their final listening event this week, leaving time for their last listening event is scheduled for the end of the week leaving time for the group to thrash out its findings.

The media has not been allowed access to their meetings so as not to constrain discussions.

But the views of the group on three key policy areas are already clear:

That the pace of change needs to be slowed down or at the very least varied across the country. In other words, no “big bang” as initially set out by Mr Lansley and a call for more piloting.That GPs alone cannot make decisions about commissioning. Other clinicians like nurses must be present on commissioning boards.That the role of the new economic regulator for the NHS must be clarified. Instead of just encouraging competition in healthcare provision it must reduce fragmentation and bring different services together.

The Future Forum will complete its listening exercise by the end of this week, but will continue to receive submissions from interested parties on Monday and Tuesday before drawing up its final report.

The British Medical Association, in its submisison to the listening exercise, has said so much may need changing that the entire bill may need to be withdrawn.

Mr Cameron has insisted the NHS in England needs to change to avoid a “future crisis” as it was hobbled by too much waste, inflexibility and top-down control.

But critics of his proposals say they were not included in the government’s coalition agreement and attempting a major re-organisation when the NHS having to find billions in efficiency savings is foolhardy.

It comes as Nick Clegg made a speech insisting that the “right reform” is introduced.

He said that while the NHS has always benefited from a mix of providers, including the private sector and charities, he will not allow the NHS to be “flogged off to the highest bidder”.

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