The government has insisted its NHS reform process is “carefully designed and managed”, in reaction to criticism from the health committee.
The Department of Health yesterday responded to the committee’s report on commissioning which said the white paper came as a “surprise” and without a “credible plan” for making the changes at the same time as huge efficiency savings. The committee is chaired by former Conservative health minister Stephen Dorrell.
The DH’s response said the proposals were foreshadowed and were “a blend of Conservative and Liberal Democrat plans”. It said: “The changes that were not in the manifestos, particularly the abolition of PCTs, are a logical consequence of the government’s proposals. For example… because of the proposed transfer of commissioning functions to the NHS Commissioning Board and GP consortia and the return of public health to local government, the government has concluded that PCTs should be abolished.”
The response said: “Transition will occur through a carefully designed and managed process, phased over the next four years… The government is proposing a phased transition, allowing enthusiasts to go early, as well as giving time to plan, to test, and to learn, under existing legal and accountability arrangements.
“We disagree with the committee’s premise that there was a surprise strategy and the finding that we have not planned for the transition or provided sufficient detail about these plans.”
The response to the committee’s report also highlights:
- The possibility of PCT clusters surviving beyond April 2013, when PCTs are due to be formally abolished, as part of the commissioning board. It says: “PCT clusters will continue to act as transition vehicles until at least April 2013… [The board] is expected to take an early view of any local support structure it needs and the extent to which clusters can act as a pathway to that structure.”
- That the changes should not be a barrier to integrated providers. The response says: “Where services are to be commissioned on an Any Willing Provider basis, commissioners will need to ensure that those services are specified in a way that does not give an unfair advantage to any provider. But this does not preclude working with a range of local clinicians to design better and more integrated pathways of care. There is nothing in our proposals to prevent networks of providers developing integrated solutions, and bidding appropriately to meet the needs identified by commissioners.”
- In authorising GP consortia the commissioning board will, “have to satisfy itself among other matters that [its] proposed constitution complies with the requirements and that the applicants have made appropriate arrangements to enable the consortium to discharge its functions”.
- Consortia will be accountable to the board and: “In turn, each consortium will have internal arrangements to ensure the accountability to the consortium of its members. These internal arrangements will be for consortia to determine, within a framework set out in legislation and guidance, which is likely to include, among other things, adherence to the ‘Nolan Principles’ of good governance.”