Health Bill 2011
News
Exclusive: Lansley assures CCGs over competition
The health secretary has written to clinical commissioning groups to assure them that that they will be in control over crucial issues such as competition, integration, and buying support services.
Exclusive: PM reveals government's four NHS commitments
The prime minister has revealed “four Fs” which he believes sum up the government’s approach to the NHS. They came while he attempted to bat off criticism of the Health Bill at a Downing Street summit today.
Exclusive: prime minister calls summit on 'implementing NHS reforms'
The prime minister was meeting today with senior health and social care leaders at a summit to discuss the “implementation of the NHS reforms” on Monday afternoon with senior healthcare leaders.
Debt cap proposed for private providers to NHS
Monitor has proposed to set a cap on the level of debt carried by any organisation providing essential healthcare services to the NHS.
DH sets aside £617m for redundancy and restructuring costs
The Department of Health has announced £617m has been put into a contingency fund for NHS reform redundancy payments and restructuring costs during 2011-12.
PM responds to HSJ's criticisms of reforms
David Cameron has defended his government’s health reforms at prime minister’s question time from the criticisms set out in HSJ’s joint leader with Nursing Times and the BMJ.
Private providers attack Monitor failure regime
Private mental health firms are lobbying for deep changes to Monitor’s proposed failure regime, claiming rules putting “patients ahead of creditors” will prevent them from borrowing.
Medical royal colleges divide over Health Bill
There is a deepening split in the position taken by the medical royal colleges towards the Health Bill.
Fixed NHS prices could become 'increasingly problematic' commission warns
The use of fixed prices to prevent competition driving down care quality could become “increasingly problematic”, a “seminal report” warned this week.
Exclusive: DH letters to staff admit 'no clarity' on jobs
The Department of Health has given NHS managers a choice of two letters to send staff this month on the future of their roles – one of which is to be used in cases where there is still “no clarity” on what will happen to their jobs.
Exclusive: Health Bill concessions on 'autonomy' and SoS accountability
The government is offering a series of Health Bill concessions in an attempt to diffuse the row over the health secretary’s responsibility for the NHS.
Private sector faces referral to Competition Commission
The NHS reforms would have “blown up in people’s faces” without last week’s decision to refer the private healthcare market to the Competition Commission, the boss of Circle has told HSJ.
Ratings agency predicts more government bailouts for loss-making trusts
There is a “very high likelihood” of continued government bailouts for struggling providers, according to ratings agency Standard and Poor’s.
Exclusive: government defending 'autonomy clause'
The government is resisting attempts to scrap the Health Bill’s so called “autonomy clause”, but close to offering a compromise amendment on the duties of the health secretary, HSJ understands.
Lords propose greater transparency in new Health Bill changes
Proposed amendments to the Health Bill would effectively subject private and third sector bodies to the Freedom of Information Act by giving commissioners more power to require information from them.
Lords pass Health Bill at second reading
The House of Lords has voted through the government’s Health and Social Care Bill at its second reading, defeating motions to place sections under greater scrutiny or stop it in its tracks altogether.
Earl Howe urges Lords to pass bill quickly
Ministers wrote to all peers this morning appealing for their support on the Health Bill after talks between Conservative and crossbench peers broke down.
NHS Confed: Health Bill could lead to vital decisions 'paralysis'
The government should change and clarify the Health Bill to help the NHS deal with its enormous financial pressures, the NHS Confederation has said.
Health Bill analysis: Lords likely to win policy shifts
Key areas of policy will come under scrutiny as the Health Bill faces its critics in the House of Lords. HSJ analyses likely changes.
Government sets out limits of Health Bill compromise
The government is prepared to compromise over how the Health Bill sets out the health secretary’s duties to ensure the NHS provides services, HSJ has been told.
Health Bill risks 'weakening ministerial accountability' - Lords committee
The Lords committee which reviews the constitutional implications of new legislation has said the Health Bill poses a risk that “individual ministerial responsibility to parliament will be diluted or that legal accountability to the courts will be fragmented”.
Nicholson: State should have power to renationalise FTs
The NHS chief executive Sir David Nicholson has told the Mid Staffordshire Foundation Trust public inquiry he would like to see the government have power to bring failing foundation trusts back under state control.
Peers take aim at Health Social Care Bill
Peers have fired an early warning shot across the government’s bows over controversial health care reforms.
Revised DH figures predict 8,000 fewer redundancies from NHS reforms
Savings from the NHS reforms will be £700m less than previously thought but 8,000 fewer redundancies will be made, according to details released by the Department of Health.
Commercial-only finance plans for FTs scaled back
The government has pulled back from plans to stimulate a market for private sector lending to foundation trusts, under which they would have been cut off from all finance other than commercial loans.
Struggling providers to get above-tariff payments
Struggling providers will be able to ask Monitor for permission to raise their prices above nationally set “tariff” rates, under proposed government changes to the Health Bill unveiled today.
'Crude' spending estimates risk CCGs' funding
Future commissioners could face “catastrophic consequences” if a rushed attempt to map current spending on GP practice populations leads to inaccurate funding allocations, experts have warned.
Flagship involvement policy faces funding threat
The success of the government’s flagship policy on patient and public involvement is at risk from “insulting” funding plans, it is being claimed.
Reform transition cost now £1.49bn, according to DH figure
A new figure from the Department of Health estimates the cost of its reform “transition programme” at £1.49bn.
Commissioning reform costs already near quarter of a billion
Nearly a quarter of a billion pounds has already been spent on the government’s commissioning reforms, with tens of millions having been paid to general practice for its involvement, HSJ can reveal.
Monitor delays chief executive appointment until bill is clarified
Monitor, the foundation trust regulator, has announced a delay in its appointment of a chief executive.
Nicholson urges MPs to end obsession with bed numbers
NHS chief executive Sir David Nicholson has challenged politicians to accept that health service modernisation will mean reducing the number of hospital beds.
Responsible officers to sit with commissioning board
Primary care responsible officers will probably sit with the NHS Commissioning Board, the Department of Health figure in charge of the policy has confirmed.
Confed chief cautions over the dangers of centralisation
The chief executive of the NHS Confederation has warned of the dangers of excessive centralisation and bureaucracy as a result of the health service reforms.
Foundation trusts borrowing over £1bn from DH
Foundation trusts have secured loans worth more than £1bn from the Department of Health, HSJ can reveal, prompting concern about the impact of increased debts on foundation trust independence.
'NHS England' name plan stirs controversy
A proposal for the NHS Commissioning Board to be known as “NHS England” is attracting criticism for inflating the organisation’s role and power.
BMA chair claims reform victory
The British Medical Association chair of council has declared a cautious victory on NHS reform at the union’s annual representative meeting.
Government plans more Health Bill amendments
Ministers are preparing a second round of amendments to the Health and Social Care Bill, HSJ has learned.
Health Bill: changes risk ‘paper duties’ and central pressure
Changes to the health bill risk propagating procedural requirements and increasing pressure on the health secretary to intervene, a lawyer has warned.
Health Bill: government publishes 181 amendments
The government has tabled 181 amendments to the Health Bill following a review of health secretary Andrew Lansley’s controversial original proposals.
Exclusive: NHS faces 'big problem' if reform timetable slips - Nicholson
The NHS faces a “big problem” if there are further delays to the timetable for developing clinical commissioning groups or moving to an all foundation trust system, NHS chief executive Sir David Nicholson has told HSJ.
DH admits preparing Health Bill changes before review report
The government was “exploring potential amendments” to the Health Bill with parliamentary lawyers before the report of the NHS Future Forum, health minister Simon Burns has admitted.
Information strategy delayed until autumn, DH confirms
The government’s long-awaited “information revolution” strategy for health has been delayed again, and will not now be released until the autumn, the Department of Health has confirmed.
Government publishes full details of reform changes
The government today published full details of the changes to its reform plans in a command paper to Parliament.
Steve Field warns of clinicians' concerns over health reforms
The chair of the NHS Future Forum has warned that clinicians fear the government’s changes to the Health Bill will slow down the pace of reform in some parts of the health service.
Commissioning board shouldn’t become ‘greatest quango’ – Nicholson
Sir David Nicholson says he will prevent the NHS Commissioning Board becoming “the greatest quango in the sky” by maintaining an “ambition” for the whole country to be covered by active clinical commissioning groups.
Nicholson: I feared Lansley’s competition rules
NHS chief executive Sir David Nicholson has confirmed he was against the government’s original proposal for a regulator promoting competition in the NHS, which was dropped this week.
Brakes on competition draw private sector complaints
Private sector players have accused the government of “very significantly” putting the brakes on its plans to extend competition from “any qualified provider” to new areas of the NHS.
Government to scrap 2014 'drop dead' deadline for foundation trust status
NHS trusts will no longer be required to reach foundation status by a deadline of April 2014, according to the government policy statement issued this morning.
Government accepts 'core' Future Forum proposals
The government has accepted most of the NHS Future Forum’s recommendations, including watering down Monitor’s role on competition and scrapping the foundation trust deadline.
Opinion
Michael White: the coalition may sustain heavy damage by seeing the bill through
What price Lansley’s eventual victory?
Does the government really have a Plan B for NHS reform?
As the Health Bill staggers through the House of Lords and opposition grows to it in a daily basis, the question is reasonably asked whether the government has a Plan B.
David Kerr: the true value of reform must be defined by patient outcomes
Rather than distracting from the NHS efficiency challenge, the Health Bill could help achieve it, writes David Kerr.
The NHS deserves a better, more open debate over health reform
The Health Bill enters the crucial report stage in the House of Lords next week amid huge controversy. To mark this, the BMJ, HSJ and Nursing Times have, for the first time, cooperated to publish the same editorial.
Media Watch: January gloom continues as colleges are next to oppose bill
‘Blue Monday’ might have been last week but the downbeat mood has continued for many in the media coverage of the health service.
'This is the kind of disruptive innovation the NHS needs'
The US integrated healthcare system Kaiser Permanente is an example of ‘innovative disruption’ in all its joined-up glory. The King’s Fund chief executive Chris Ham highlights some of the benefits a similar system could give the NHS.
Phil Hammond: the reforms remain more question than answer
Fresh from his appearance on BBC1 two weeks ago, Dr Phil Hammond argues that the benefit of NHS reform is still no clearer to being understood, and that a change in direction is needed. It might just win over Andrew Lansley’s critics, too.
'An important moment in public health history'
Ruth Hussey, the woman at the heart of smoothing the public health shake-up, says there will be great gains after the strains. She talks to HSJ deputy news editor Steve Ford.
'After destructive debate, the case for reform needs to be rebuilt'
The government needs to find a way to make the ingredients of reform seem like opportunities for positive change rather than threats, writes Asthma UK chief executive Neil Churchill.
Media Watch: calls to 'kill bill' go unheeded
On Monday the national press speculated on the fate of the Health Bill before its appearance in the Lords later in the week.
'Healthcare without competition is financially unsustainable'
Despite increased competition raising fears, in some quarters, for the future of the NHS, now is not the time to play it safe - but to harness its power to do great things, says Sir Stephen Bubb.
'If the reforms go wrong, the potential risk to public health huge'
Andrew Lansley’s new vision for public health must overcome tough tests if it is to grow into a healthy being, says Alan Maryon-Davis.
'The focus now for those who manage healthcare should be value'
Now that the dust has settled somewhat on the furore surrounding the Health Bill, I find myself thinking about the domestic and truly international health agenda.
Sue Slipman: public board meetings are not a quick fix for accountability
With transparency and accountability increasingly on the agenda for trusts, Foundation Trust Network chief executive Sue Slipman argues that holding board meetings in public as a means to that end is not simply an open and shut case.
Local services need the backup of national support
We’ve all gone local these days. The health secretary is handing power to GPs. NHS chief executive Sir David Nicholson is giving a bigger say to patients.
Power to the patients: promised improvements to patient choice need backing up
A change in what “choice” represents in policy has great potential for patients. Now that change needs to be backed with a firm will to implement it, writes Health Foundation chief executive Stephen Thornton.
Andrew Lansley: the strength of feeling shows why we had to listen
Readers of HSJ will need no reminding that the NHS Future Forum recently published its recommendations on the Health and Social Care Bill. Nor that parliamentary scrutiny has begun on its amendments.
'We have to tackle government disagreement head on'
With management levels cut dangerously low in the health service, the NHS Confederation’s chief executive Mike Farrar tells HSJ’s Charlotte Santry the days of biting tongues when dealing with those in power are definitely over.
Media Watch: printing the unprintable on hospital closure
The papers have been jostling to say the previously unsayable this week and break the political taboo that some hospitals must close if the NHS is to remain clinically safe and financially viable.
The government shouldn't simply leave the past behind
The government is in a tough spot at the moment, but it can be eased if it heeds the lessons of the NHS Plan era, argues House of Lords independent member Nigel Crisp.
Media Watch: elderly care abuse revelations dominate discussion
The Daily Telegraph started the weekend with a rare morsel of good news for Andrew Lansley.
The government's failure to justify reform has left the public short of options
Huge strides have been taken to offer NHS patients a choice of different providers, but there is now a real chance of a backwards step under the coalition government, says management consultant Paul Corrigan.
Media Watch: Health Bill pause doesn't halt continuing coverage
As the coalition’s “pause” rumbles on so do the stories surrounding the fate of the Health and Social Care Bill.
'I'm more excited than ever about the healthcare marketplace'
Competition on everything including price is not only the most practical solution to the growing pressures facing the NHS, it is also virtually inevitable, according to the chief executive of the UK’s largest private healthcare provider.
Mark Britnell: the NHS funding model is no longer 'resilient'
A sophisticated discussion on how – and how much – the health service should be funded is badly needed to avoid undoing two decades worth of progress.
Passing judgement on Lansley's vision
A year after the general election, Andrew Lansley and his controversial reforms are under fire. HSJ asks four leading figures - Stephen Dorrell, David Kerr, Alan Milburn and Bill Moyes - to hand down their verdict on Lansley’s vision.
'Without evidence, the rhetorical reforms are irrelevant at best'
As real funding is eroded amid grand health policy rhetoric, there is a desperate need for hard evidence and data to inform the fundamental policy challenges facing this government. Without it, the reforms are all but irrelevant, argues York University professor of health economics Alan Maynard.
The debate on consortia governance requires sound principles, and hard evidence
To commission effectively, consortia will need governance arrangements that create confidence and trust, and build legitimacy and partnerships, writes The Health Foundation chief executive Stephen Thornton.
Is the NHS constitution still relevant in the new NHS landscape?
Since the government came to power and the health secretary announced sweeping reforms to the NHS, there seems to have been little focus on the NHS constitution. Gerard Hanratty, partner at healthcare law firm Capsticks, weighs up what may happen to it under the coalition government.
Performance surplus hides the fact many trusts are facing critical finance problems
Trusts with serious financial problems are in danger of being overlooked as a surplus on “aggregate performance” comforts some in the NHS. Nick Bosanquet looks at five ways to avert the hidden crisis.
Media watch: someone needs to get a grip on reforms
There was little room for domestic issues amid wall to wall coverage of events in Libya and Japan in the papers this week, but nevertheless the Sunday Telegraph managed to maintain the pressure on health secretary Andrew Lansley.
'GPs run the risk of alienating themselves from their colleagues'
As the BMA gears up for a crisis meeting to debate the Health Bill, the chair of its consultant and specialists committee voices his fears of a huge split between members - and a ‘seething cauldron’ of competing providers in the future.
'Without a firm battle plan, consortia might find themselves neither here nor there'
The grand old health secretary risks getting the new consortia stuck on the hill, unless a change in strategy to push them higher up the slope of success is attempted.
Media Watch: letters from David Cameron
Not satisfied with the “see it from space” scale of the current NHS reorganisation, the Daily Telegraph warned another change of “seismic” proportions is heading the public sector’s way.
Bill Moyes: the reform agenda presents a massive opportunity
The government’s reform agenda for the NHS isn’t the beginning of the end of a primarily tax funded healthcare system. The reforms are probably the best way to preserve that for another generation or more. So, instead of focusing on the risks, let’s give more attention to the opportunities.
'It makes a welcome change to hear praise for NHS managers'
Sir David Nicholson’s letter to colleagues after the spending review recognised that great public service leadership “more than anything else” will be central to improving quality and productivity.
Is a narrative for complex health reform impossible?
Two snapshots from a day in the life of one A Lansley, health secretary.
Michael White: opposition's political artillery fire rings hollow
A barrage of political artillery fire preceded Monday’s Commons second reading of the Health and Social Care Bill.
The NHS might be being rewired, but its electricity runs to much the same effect
The Health Bill has set a new record as the largest piece of NHS legislation ever tabled. Health secretary Andrew Lansley described it as “evolutionary” – the mind boggles at what he would consider “revolutionary”.
Private sector takeover not as imminent as some may have it
The week began with a media feeding frenzy around the government’s NHS reforms created by the imminent publication of the health bill. Dire warnings were ten a penny, while the PM adopted a Thatcherite “no alternative” stance.
Michael White: a deal must be cut to restore certainty to the NHS
It’s surely good news that health ministers are to encourage medical staff to ask patients about their lifestyle choices, as ProfessorSteve Field’s NHS Future Forum has been suggesting - though in my experience they have been doing it for ages.
Protecting the public from public health professionals
The statutory regulation of public health specialists is a little known and rarely discussed issue, but it needs close scrutiny to improve the protection patients receive against professionals whose practice could cause loss of life, says Lindsey Davies.
'Healing our finances needs a long term, not short term, strategy'
The financial problems of the NHS are extremely serious – but more like anaemia than haemorrhage. It is the financial equivalent of a long term medical condition, says Nick Bosanquet.
Sally Gainsbury: councils face a rude awakening
I spent a day and a half last week listening to council executives talking about their hopes and fears for the new roles due to be bestowed on them by the Health Bill.
What the new healthcare environment holds for clinical negligence indemnity
Changes ushered in by the Health Bill will mean indemnity contracts between providers and commissioners will need to be considered carefully and satisfy both sides before being set in place. Medical Defence Union chief executive Dr Christine Tomkins explains.
'The independent sector has a track record of serving patients extremely well'
The hostile opposition towards private involvement in NHS provision is growing ever louder. But politics is getting in the way of policy, and the private sector is not the villain in NHS reform, argues NHS Partners Network director David Worskett.
Noel Plumridge: parallel process in danger of doubling costs
First, in April, came the “pause” in the passage of the Health Bill. Then the “listening exercise” and the appointment of the NHS Future Forum. And, along the way, the Liberal Democrats’ humiliation in the May elections.
Your humble servant: can you hear me, Andrew Lansley?
From being everywhere to suddenly being nowhere, your humble servant goes in search of the health secretary.
The barriers to achieving cost effective interventions
A lack of clarity around the effectiveness of out of hospital interventions is preventing their potential cost efficiencies from being realised. But, says Nuffield Trust director Jennifer Dixon, there are reasons to be cheerful.
