Health Care Bill Puts Focus On Quality

Plans to modernise the National Health Service and put quality of patient care at the heart of everything it does were set out in the Health and Social Care Bill, published today.

The proposed changes will lead to better quality care, more choice and improved outcomes for patients, as well as long-term financial savings for the NHS, which will be available for reinvestment to improve care.

Under the new measures there will, for the first time, be a defined legal duty for the NHS and the whole care system to improve continuously the quality of patient care in the areas of effectiveness, safety, and - most importantly - patient experience.

The Health and Social Care Bill 2011 includes proposals to bring commissioning closer to patients by giving responsibility to GP-led groups and increase accountability for patients and the public by establishing HealthWatch and local health and wellbeing boards within local councils.

It will also liberate the NHS from political micro-management by supporting all trusts to become foundation trusts and establishing independent regulation and improve public health by creating Public Health England and reduce bureaucracy by streamlining arm's-length bodies.

These measures will also save the NHS over £5 billion by 2014/15 and then £1.7 billion every year after that - enough money to pay for over 40,000 extra nurses, 17,000 extra doctors or over 11,000 extra senior doctors every year.

The majority of the savings would come from a significant reduction in bureaucracy following the abolition of strategic health authorities and primary care trusts, and a reduction in management staff by an estimated 24,500 posts.

The changes would pay for themselves by 2012/13 and the subsequent savings would give the NHS a stable financial basis for the future.

Health Secretary Andrew Lansley said: "Modernising the NHS is a necessity, not an option - in order to meet rising need in the future, we need to make changes.

"We need to take steps to improve health outcomes, bringing them up to the standards of the best international healthcare systems, and to bring down the NHS money spent on bureaucracy. This legislation will deliver changes that will improve outcomes for patients and save the NHS £1.7 billion every year - money that will be reinvested into services for patients," he said.

For doctors, Dr Hamish Meldrum, Chairman of Council at the BMA, said: "Ploughing ahead with these changes as they stand, at such speed, at a time of huge financial pressures, and when NHS staff and experts have so many concerns, is a massive gamble.

"The BMA supports greater involvement of clinicians in planning and shaping NHS services, but the benefits that clinician-led commissioning can bring are threatened by other parts of the Bill.

"In particular, the legislation will allow competition to be forced on commissioners, even when they believe the best and most appropriate services can be provided by local hospitals," he said.

"Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients.

"Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services.

"Commissioners should be free to choose the best and most appropriate providers, creating care pathways across hospital and community care boundaries, without fear of a legal challenge from private companies or the health regulator," the top doctor insisted.

"The scope and complexity of the Bill is immense and will have significant impact on the future of NHS services as well as for the NHS workforce and public health.

"The BMA will examine the it in great detail and will be lobbying very hard to amend the most damaging aspects of this legislation," Dr Meldrum concluded.

Sir David Nicholson, NHS Chief Executive, said: "It is critical for the service to keep its focus and purpose of improving quality for patients and to make the reforms a foundation for improvement.

"This is a major challenge when we are already planning to make £15-£20bn efficiency savings but I am confident we will be able to do this, to establish a health and care system that achieves the best outcomes for patients."

(BMcC/GK)