The government has published a detailed blueprint of its plans for the NHS, bringing together previous policy commitments from the Lib Dems and Conservatives.
Among the plans is a commitment that primary care trust boards will have directly elected members.
The rest of the board will be appointed by the local authority with PCT chief executive and other “principal officers” appointed by the health secretary on the advice of the new independent board.
The coalition document, published this morning and unveiled at a press conference by David Cameron, Nick Clegg and senior ministers, said the new independent board would “allocate resources and provide commissioning guidelines”.
The paper also pledged to “strengthen the role of the Care Quality Commission so it becomes an effective quality inspectorate” and develop Monitor into an economic regulator overseeing “aspects of access, competition and price-setting in the NHS”.
The agreement says the government will “strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf.”
But it added PCTs would “commission those residual services that are best undertaken at a wider level”.
The NHS will also develop a 24-hour urgent care service in England, “including GP out-of-hours services” with a renegotiated GP contract and an incentive system to improve primary care in “disadvantaged areas.”
There was also a commitment to let patients choose their GP.
Without specifying which, it promised to “significantly cut the number of health quangos” and cut the cost of “NHS administration by a third”.
The document said the government would stop the closure of A&E and maternity wards if they were “centrally dictated”.
It also pledged to “reform” NICE and move to “a system of value-based pricing” to get promote better access to “treatments their doctors think they need.”
The last pledge in the document was “to give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices”, specifying independent, voluntary and community sector providers.
David Cameron told the press conference the coaltion health policy was “more radical, more de-centralising” than either party had planned.
Hospices and providers of palliative care will be funded per-patient, with children’s hospices receiving £10m a year from the DH.
Commenting on the announcements, director of the Primary Care Foundation Rick Stern welcomed moves towards “democratising PCT boards” but said there would always be tension between GP-level and larger scale commissioning.
He said: “The question marks would be over how they are going to provide the resources and support to enable GPs to really do that. The obstacles are how the resources are going to be provided to let people do it and how we can be sure the bureaucracy lets go.”
He added: “probably the majority [of GPs] have limited interest in being involved in the wider commissioning of services.”
NHS announcements from the coalition document
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Coalition document sets out raft of NHS reforms