Health news

The Health Bill: FAQ

What changes are being proposed?

19th January 2011 -- The main change will see GPs becoming much more responsible for managing the way money on health services is spent.

GPs would be encouraged to form consortia to take charge of most of the health budget - estimated at around 80% of spending.

The Government’s ambition is to have 500 consortia in place so that the new arrangements can be up and running by 2013.

The changes only apply in England because health is a devolved issue in the rest of the UK.

What’s wrong with the old system?

At present, money for health is passed from Strategic Health Authorities to Primary Care Trusts (PCTs), which are responsible for managing finances and paying for services, but the Government says this is too bureaucratic.

It believes GPs are best placed to decide how funds should be spent because they are closer to patients and understand their needs better than health managers.

Ministers believe the change will mean patients get better care while ensuring that NHS services are used more efficiently.

Once the new system is established, the Strategic Health Authorities and the PCTs will be scrapped.

Shouldn’t GPs be looking after their patients, not acting as accountants?

Critics have grave misgivings about whether GPs are qualified to handle such huge budgets, but the Government says that they won’t be left on their own.

The consortia will be overseen by a national NHS Commissioning Board, which the Government says be independent of central control.

Also, groups known as Health and Wellbeing Boards will be established with the aim of linking GP consortia with other health and social care providers.

The Department of Health says that as these Boards will be within local authorities, councils will have a stronger voice in deciding on healthcare arrangements for local communities.

Under the changes local authorities will also be put in charge of promoting public health.

How have the proposals been received?

The scale of the changes has set alarm bells ringing for some. Health professionals and politicians are sceptical about whether the changes will save the NHS £5 billion by 2014-15 and £1.7 billion every year after that, as the Department of Health insists.

MPs say that the Government’s ambitions seem to have escalated since last spring. The Commons Health Committee said the coalition Government originally announced “an evolution” of the existing system, but that by the time Health Secretary Andrew Lansley published his White Paper this had become “institutional upheaval”.

Health unions are concerned too.

The British Medical Association, The Royal College of Nursing and the Royal College of Midwives have said that the scale and the pace of change, coupled with the need to make £15-20 billion ‘efficiency’ savings, is “risky and potentially disastrous”.

They are also worried that the ethos of the NHS is being undermined if GPs are able to commission health services “from any willing provider”. They fear this might mean partial privatisation.