Cameron backs Lansley's handling of reforms

Asked if he had learned lessons about government from the fiasco around the health bill, Mr Cameron said he stood by the decision to “pause” its progress.

He said: “The whole coalition cabinet went along with these reforms; the whole cabinet decided to press the pause button.

“I accept full responsibility for the reforms going ahead in the way they did. I think Andrew has handled this situation extremely well.”

Mr Cameron and Mr Lansley were joined by deputy prime minister Nick Clegg to announce the government’s response to the Future Forum’s recommendations at Guy’s and St Thomas’ Hospital.

Mr Lansley said the government had accepted all of the forum’s “core” recommendations including the creation of clinical senates and had “listened and learned”.

The health secretary denied that the proposed new architecture of clinical commissioning groups, clinical senates and clinical networks would prove more unwieldy than a primary care trust.

“The point is that inside primary care trusts there was all of this paraphernalia of committees but it didn’t actually deliver the things that people really need. It didn’t deliver joined up care; it didn’t deliver quality; it didn’t get the service to respond to the outcomes of patients,” he said.

In their speeches all three politicians insisted the bill had always been about evolution rather than revolution and focused on how the amended bill would improve integration between health and social care. Mr Cameron said the government planned to “explore ways of bringing different pots of money across health and social care together”.

However, the bill will go back to commitee stage of the House of Commons. It had completed this stage and was due to go the House of Lords when the “pause” was announced.

Asked how the use of competition would change under the new bill, Mr Lansley said it would slow down the introduction of any qualified provider and that competition “would not be driven by Monitor but be responsive to the needs of patients”, with Monitor banned from breaking up integrated care pathways by imposing competition.

Mr Cameron said the reforms would allow “competition and diversity to come through bottom up choices not through top down dogma”.

He added: “The bureaucrats are going to work for the doctors, not the doctors working for the bureaucrats.”