Lansley faces opposition to white paper

Growing concerns about the government’s plans to overhaul the NHS have been presented to health secretary Andrew Lansley ahead of the Conservative Party’s health debate today.

Lansley is likely to tell his audience in Birmingham that there will be no U-turn on his plans to abolish primary care trusts and strategic health authorities and pass 80% of the NHS budget to GPs.

However, formal responses to a consultation on the white paper, ‘Equity and excellence, Liberating the NHS’, suggest they have received a generally negative response from NHS staff.

Last week the BMA said that although it supported the idea of devolving control to professionals and patients, there was “much that would be potentially damaging” in the reforms.

This week bodies speaking for nurses, PCT managers, GPs and NHS workers issued equally guarded responses to the consultation, which ends on 11 October.

The NHS Alliance, an independent body whose members include PCT managers and GPs, published a survey that it said showed NHS staff supported GP commissioning but were divided on the details.

The Alliance’s survey of more than 200 PCT managers, clinicians and practice managers found that almost 90% backed the plan to pass budgets to GP consortia. 

But only 35% felt the timeline for developing the new system was realistic or achievable and 85% said PCTs must have a role in supporting the transition.

Dr Michael Dixon, chair of the NHS Alliance, said: “Understandably, people are concerned about many issues, including the payment systems and expectations that GP consortia will have to do too much.”

He said it was important that GP consortia were not put in the same position as PCTs “which are swamped in paper work and other pressing demands.”

The Royal College of Nursing said the scale and speed of reforms posed a significant risk to the NHS in England. While it welcomed the principles of patient-centred care and greater freedom for staff, only 20% of members felt the reforms would result in better patient care.

Peter Carter, the RCN’s chief executive and general secretary, said: “The RCN is not opposed to change, but it is critical that reforms are tried and tested with a strong evidence base behind them that staff feel they can support.

"Furthermore we are concerned that flexible local implementation of the reforms could result in the development of unacceptable regional variations in access to services or quality of care.”

Public sector union Unison, which is already seeking a judicial review over the lack of consultation on principles behind the white paper, claimed the government’s proposals were “an £80 billion gamble” that would wreak havoc with patient care.

And former health secretary Andy Burnham wrote an open letter to Andrew Lansley claiming that Labour would “launch a major campaign in every community” if the government went ahead with its plans on its proposed timeline.

EHI Primary Care’s own survey of 400 PCT and SHA staff, published last week, found that more than 50% of respondents believe that the white paper will lead to a deterioration in patient care. A further third (33%) expected to see no change in patient care from the government reforms.

Last week, Lansley said he welcomed the BMA’s support for GP commissioning and said healthcare professionals were best placed to make decisions about the best use of resources to improve outcomes for patients.

He added: “There are many GPs across the country who are keen to make the transition quickly, others want to know more about how it’s going to work before they implement it.

"This is what the consultation process is about, everyone coming forward to say how we can make this work.”

Read more: analysis of the EHI Primary Care Survey of staff working in strategic health authorities and primary care trusts in Fiona Barr’s feature, Uncertain times.