No big shift in government Health Bill amendments

The changes address some of the concerns raised most vocally in the Lords but there do not appear to be any substantial policy shifts.

A DH statement today said there would be changes to “establish express power for Monitor to set and enforce licence conditions [on providers] for the purpose of enabling integration; and for the purpose of enabling cooperation”.

There will also be amendments to requirements on CCGs and the NHS Commissioning Board to involve patients. The DH said it would change wording to make sure the duties “encompass the full range of activity that could be provided as part of the health service”.

Another change will require the commissioning board to issue guidance to CCGs on how they involve patients.

There will be a new requirement for the commissioning board and CCGs to account in their annual reports for what they have done to fulfil their duties to reduce health inequalities.

And the requirement on the health secretary, commissioning board and CCGs to “have regard to the need to promote research” will be simplified to a requirement to “promote research”.

As revealed by HSJ, the government has previously said it will accept a series of amendments making clear the health secretary’s accountability and responsibility for the health service, and giving him or her a “duty to have regard to the NHS Constitution”.

The government is not proposing any shift on a number of controversial issues including foundation trusts’ private patient income, conflicts of interest in CCGs, and the independence of patient organisation HealthWatch England.

Labour frontbenchers peers will seek to win votes on further changes during the bill’s report stage in the Lords which was due to begin on 8 February.

The government will hope its own amendments, due to be tabled yesterday, will help it retain enough support among Liberal Democrats and crossbenchers.

A government source said the new changes were intended to “clarify that this bill is about handing power to GPs and putting patients at the heart of the health system”.

Patient group umbrella organisation National Voices has been calling for more detailed requirements to involve patients since early last year. Its head of policy Don Redding said it welcomed the change, and that it would be further detailed in commissioning board guidance.

He told HSJ the change was a “clear signal that commissioners should be making sure patients are more engaged in their own care and treatment”.

He said: “Engaging patients is one of the best evidenced areas for changing the culture of NHS care. It means engagement of patients in the process of their own care and treatment; working with professionals as partners; and getting access to all the information you need.”