GPs warn bill could 'unravel' NHS

 9 May 2011 Last updated at 02:58 ET By Branwen Jeffreys Health correspondent, BBC News  The government says the NHS has to "modernise" through reform. The government needs to rewrite a key part of its Health Bill which encourages greater competition, the Royal College of GPs says.

Dr Clare Gerada, the chair of the college, says otherwise the bill risks "unravelling and dismantling" the NHS.

The government says it wants competition based on quality not price to deliver better results for patients.

It is looking at the role of choice and competition as part of its listening exercise on the Health Bill.

Dr Gerada told the BBC the bill would remove the health secretary's duty to provide a comprehensive healthcare system across England.

"If that duty goes our fear, and that of many others, is that it will open up the NHS to patients being charged for certain parts of their services," she said.

"It appears that we are moving headlong into an insurance-type model of the NHS."

Pressure for change

The Royal College is one of a number of organisations lobbying Downing Street directly to make changes to the draft legislation.

There is also political pressure within the coalition following significant unease within the Liberal Democrats.

Nick Clegg has warned his party will block the Health Bill unless it is altered.

The BBC has seen the 26-page analysis sent by the Royal College of GPs to the prime minister's office.

Some parts of the government plans are welcomed, such as the greater involvement of GPs in buying and planning care.

But it also challenges the need for a greater market in healthcare and for the first time calls for the entire section on competition in the bill to be rewritten.

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I would hope that during this pause the government will reflect on what we're all saying and will rewrite the part of the Bill that is actually risking the NHS and risking the NHS being unravelled irreversibly for ever”

End Quote Dr Clare Gerada Royal College of Surgeons Dr Gerada told the BBC the changes needed went far beyond any modest alterations.

She said: "I would hope that during this pause the government will reflect on what we're all saying and will rewrite the part of the bill that is actually risking the NHS and risking the NHS being unravelled irreversibly for ever.

"And delivering in the end worse patient care - care that is more expensive for the taxpayer."

Dr Gerada said the government had to realise that the concerns were nothing to do with the other parts of its plans, which give groups of family doctors control over budgets.

She said that as GPs had begun to understand the implications of competition element the anxiety about what it means for the health service had grown.

'No competition on price'

The government has already conceded it needs to consult more widely on its plans for the NHS in England.

More than 100 "listening" events are being held around the country, including some with staff and patients.

This is in addition to the 6,000 responses to its official consultation last year.

The Health Secretary Andrew Lansley said the priority was making sure competition works for patients.

"We have been clear that we want to see competition based on quality, not on price, to deliver better results for both patients and the taxpayer," he said.

Some believe the government could address the concerns by redrafting parts of the Health Bill to make clear how and where it thinks competition could be of value.

That would involve setting limits to the role of Monitor, which is to become the economic regulator of healthcare.

David Cameron is taking a much closer interest in the details of the bill.

Parliament debate

His newly-appointed advisor on health policy has already begun a series of informal meetings with senior academic, former NHS managers and groups representing health service staff.

An extra special adviser is to be deployed to the Department of Health to help with communicating the complicated reforms.

Labour has called a debate in Parliament on Monday on the changes to the health service.

Shadow Health Secretary John Healey said it was now up to Mr Cameron to have the final say on the NHS plans.

"If the prime minister wants to prove to NHS patients and staff that his 'pause' is not just spin then he must shelve the bill as it stands and make radical changes to his NHS reorganisation plans," he said.