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Cameron outlines reform changes

David Cameron has signalled a series of major concessions in the coalition's controversial NHS shake-up.

The Prime Minister admitted his government had 'learned a lot' from the storm of criticism that has engulfed the proposals and promised there would be no 'sell-off' of services.

But he also insisted it had been right to pause the legislation and the debate had convinced people that the NHS did need radical reform to avoid buckling under increasing demands.

Labour leader Ed Miliband dismissed the intervention, in a speech at a central London hospital, as evidence of the chaos and confusion the coalition was wreaking on the health service.

The government is expected to unveil full details of its reworked health plans next week after the outcome of a consultation exercise is published.

However, Mr Cameron pre-empted the results by indicating that the overhaul would include:

  • Involving hospital doctors and nurses - not just GPs - in commissioning
  • Scrapping the April 2013 deadline for consortia to take responsibility for commissioning
  • Creating 'clinical senates' to bring together healthcare professionals to oversee the integration of care over wide areas
  • Giving health regulator Monitor a duty to promote integration.

The premier also sought to reassure critics that there would be no dogmatic pursuit of competition, private firms would not be able to cherry-pick the most lucrative services to provide and targets on waiting times would be kept.

Copyright © Press Association 2011

Your comments (terms and conditions apply):

"I think this government are living on a different planet. There is already great loss of nursing staff and the staff who are left to work in the hospitals and care homes are under more stress. Patients are not getting the care they deserve because of this and most nurses are not happy with this and there is no doubt nursing morale is on a definite low. Most of them feel how can they give the best care when numbers are stretched to the limit. As for nurses being involved in the descision-making I find that hard to believe, because as a practice nurse who has worked in primary care for umpteen years I find that GPs don't often listen to suggestions that are made within the practice to help with patient care. So I am very sceptical that this will work" - Name and address supplied 

"I completely agree with V Henry's comment. The NHS is fast becoming unsustainable. There is a lot of exploitation that is done by the people themselves in using the NHS. Health is basically an individual's responsibility. The NHS is of course
there to look after the really sick responsible public. I am not saying that those who get irresponsibly ill in one way or another are not entitled, all I'm saying is, there should be a good check and balance to where this NHS lies in terms of those who seem to repeatedly get irresponsibly ill even after sound management and guidance and just simply chooses to carry on in their unhealthy habits" - Name and address supplied

"Cameron has never really stated the reasons why the NHS needs such radical reform. Honesty may provide the answer privatisation by the back door. All governments have talked about reducing beaurocracy but none have delivered, this would be a helpful situatuation to address. The patient may yet again be the loser as the services altready being cut are clinical
nursing posts" - Sheila Grundy, Lancs

"I think the government needs to be very cautious. Nurses need to be involved in all aspects of the change. Lots of nursing jobs are being lost, to what cost? Vulnerable people are already losing out and this will get worse as the year-on-year savings start to bite ... worried!" - Chris Kay, Huddersfield

"I think the man is a fool" - Lenny Allen, Dumfries

"I think the proof will be in the pudding - let's see just how much nurses will be 'allowed' to be involved - I have a feeling it will be minimal and GPs will continue to have the upper hand!" - Louise Lewis, Bradford

"The only good thing about the reforms was it should have cut down paperwork and red tape. Ho hum ... back to management by committee so everything will take longer and cost more. Is it just me or does this all feel revoltingly familiar?" - Name and address supplied

"The government should have been brave enough to stick to the agenda for changing the present dependent culture of everyone on the heath service. It is simply not sustainable, changes do have to be made and as taxpayers we need to realise that money comes with responsibility and monitoring of
it's use in all areas of health. Personally I would welcome more emphasis to be given on health education and a pro active approach to health and attempts to be made to change the culture that the health service is here to pick up all ills irrespective of costs" - V Henry, London