SWEEPING changes that pull the plug on the government's NHS 'revolution' appeared to have finally won the backing of health professionals last night - and of coalition MPs.
Clinicians and NHS managers gave a warm welcome to a hastily written overhaul of troubled Health Bill, to be confirmed by David Cameron today.
Rebel Liberal Democrat MPs said their key concerns - over huge budgets being handed to GPs, a lack of democratic accountability and creeping privatisation of the NHS - had now been met.
And there was only muted criticism from Tory right-wingers, who fear the prime minister has botched a golden opportunity to introduce a fully-fledged market in the NHS, under Lib Dem pressure.
The reaction followed a scathing report by the NHS Future Forum, set up to rescue the Bill after an outcry forced Mr Cameron to announce a two-month "listening exercise".
The experts, led by Birmingham GP Steve Field, warned that Health Secretary Andrew Lansley's original blueprint had sparked "genuine and deep-seated concerns from NHS staff, patients and the public which must be addressed".
It recommended big changes, including:
• Nurses, specialist doctors and other clinicians, as well as GPs, should 'commission' care - and should meet in public, to ensure "transparency about how public money is spent".
• The bodies should take over responsibility only after they "demonstrate they have the right skills, capacity and capability" - ripping up the original 2013 timetable.
• Competition, allowing private firms to grab NHS services, should only be allowed "to secure greater choice and better value for patients. It should be used not as an end in itself".
• The health secretary should retain ultimate accountability for the NHS in England - a responsibility that Mr Lansley sought to abandon.
However, primary care trusts (PCTs) - which employed 4,000 NHS staff across the region, before jobs started to be shed - would still be abolished, by 2013.
As a temporary measure, the job of organising local health services, in areas where clinicians are not ready, would be handed to a new independent 'NHS Commissioning Board' - in London.
Tom Blenkinsop (Lab; Middlesbrough South and East Cleveland), who sat on the Health Bill committee, warned he changes did not go far enough, adding: "It is time to scrap this Bill and conduct a proper review of the long-term needs of the NHS."
But Dr Hamish Meldrum, head of the British Medical Association (BMA), praised a "refreshing experience", adding: "The Future Forum's recommendations address many of the BMA's key concerns."
And Mike Farrar, chief executive of the NHS Confederation, said: "This report makes big strides in the right direction and has a real chance of getting NHS reform on the right path."
The prime minister will hope to kill off the NHS as a political controversy when he accepts the recommendations today - although the Bill will be delayed by several months.
Dr Stuart Findlay, a Bishop Auckland GP and spokesman for the County Durham and Darlington Pathfinder Consortium, said the main recommendations seemed to echo David Cameron's speech last week in which he promised concessions.
But Dr Findlay said: "I think it is a good thing that any willing provider remains in place...we would only bring in other providers if we were having a problem with the current service. "Its a relatively rare event for that to happen but you do need that lever so that GPs can get better care for their patients."
He said it was now time to get on with the reforms.
"This pause and all of the upheaval has been very damaging," he added.
Dr John Canning, a Middlesbrough GP who sits on the national GP committee of the British Medical Association, said: "I think the most important issue is that Monitor's role is going to be changed."
Dr Canning also welcomed the recommendation that GP consortia would have to consult more widely with their hospital colleagues and other clinical groups before taking commissioning decisions.
"But we don't just want one hospital doctor involved in some tokenist way in the process. We need to be able to go to the right person," he added.
Professor David Hunter, an expert on health service management, said the report: "Is a bit of a fudge which, I suspect, will not silence all of the critics."
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