Miliband's CCG vision at odds with Burnham plan

In a speech on Monday evening in which he advocated a new culture for public services, the Labour leader suggested that CCGs would draw up plans to reconfigure services if his party won power. He said that consultation on such changes should be led by other bodies, such as health and wellbeing boards.

This appears to be at odds with a proposal devised by shadow health secretary Andy Burnham last year in which the vast majority of NHS expenditure would be channelled through local authorities.

• Michael White: Miliband’s direction lacks the Blair flair

Under his vision, health and wellbeing boards would become the “pre-eminent” decision making bodies across the health and social care system while CCGs would merely have an advisory role.

Mr Burnham’s proposals did not become party policy but were examined by to the independent commission on whole person care, which was led by former Department of Health clinical lead for efficiency and productivity Sir John Oldham.

The report is expected to be published before the end of March.

In his speech, Mr Miliband said: “No change could be proposed by a clinical commissioning group without patient representatives being involved in drawing up the plan.

“Then when change is proposed, it should be an independent body such as the health and wellbeing board that is charged with consulting with the local community. Not, as happens now, the hospital trust or commissioning group that is seeking the change.”

A Labour spokesman said Mr Miliband’s comments “complemented rather than contradicted” Mr Burnham’s idea. Following Mr Miliband’s speech, Mr Burnham followed suit with one of his own on Tuesday.

The shadow health secretary backed the idea of a year of care tariff for hospital care in preference to payment by results. However, he did not specify whether CCGs or HWBs would be in charge of the allocations for this tariff.

In his speech at NHS England’s medical leaders conference, Mr Burnham called for “a new priority on generalist care” and said that medical training had been “too specialist and narrow for too long”.

Mr Burnham said district general hospitals would benefit from NHS organisations being designated as preferred provider of services to “grow over time into an entirely different entity − an integrated, generalist care provider working from home to hospital, coordinating physical, mental and social care”.