More power to frontline NHS staff

Doctors are to get more control over NHS budgets

The government has announced plans to give doctors, nurses and other health workers more control over the future shape of the NHS.

The Queen's Speech contained no initiatives to give the private sector a greater role in the delivery of NHS services.

However, such moves, which have been strongly hinted at by Tony Blair, may not require legislation.

Controversially, there are no plans to bring forward legislation to ban tobacco advertising.

Until we get thorough ownership of budgets, we will not be able to make the changes that people are looking for

Dr Mike Dixon

An NHS Reform Bill will contain proposals to give doctors, nurses and other frontline health professionals, working together in Primary Care Trusts, control over 75% of health service spending by 2004.

Ministers feel that frontline heath professionals are better informed about patients' needs and wishes, and therefore better placed to decide how services are provided locally.

They aim to give these doctors and nurses the freedom to shape services in a way that they see fit

Primary Care Trusts will also take over responsibility for GPs, dentists, opticians and pharmacists from health authorities.

Dr Mike Dixon, chairman of the NHS Alliance, which represents Primary Care Trust staff, welcomed the plans.

He said: "At the moment there is little room for manoeuvre. Until we get thorough ownership of budgets, we will not be able to make the changes that people are looking for."

Patient power

Ministers say the proposed Bill will also contain measures to give patients a greater influence on the running of the NHS.

The public will be invited to join democratically elected local bodies set up to scrutinise the local health service.

These bodies will be able to refer any contentious changes in provision to a new National Reconfiguration Panel, which will decide whether they can be justified.

However, opponents fear that the bodies will lack the independence of the current system of community health councils.

Self regulation

The Bill will also contain plans to strengthen regulation of the health profession.

This will mean reform of the General Medical Council, which has come under intense criticism following high profile cases such as at that of the Bristol heart babies, the organ retention scandal at Alder Hey Children's Hospital, and the mass murderer Harold Shipman.

The GMC is already consulting on options for reform.

The Bill will also modernise the way appeals from decisions of regulatory bodies are handled, and the way they are accountable to parliament.

No tobacco ban

I am shocked and disappointed that, after what ministers have said about the importance of this legislation, it is now being shelved

David Hinchliffe MP

However, there are no immediate plans to introduce a bill to ban tobacco advertising.

The failure to address the issue has provoked condemnation not only from anti-smoking campaigners, but from the Labour chairman of the influential Commons Select Committee on Health.

David Hinchliffe said: "I am shocked and disappointed that, after what ministers have said about the importance of this legislation, it is now being shelved.

"Six months ago, Alan Milburn told the House of Commons that smoking is the biggest public health problem faced by the country, and that it was essential to get this law on the statute books.

"Now it seems that the government has changed their mind and it can wait a while."

Dr Ian Bogle, chairman of the British Medical Association, said: "I am shocked and dismayed that the Government has not made room in its programme for a bill to ban tobacco advertising. Tobacco is a public health menace."

Dr Evan Harris, Liberal Democrat Shadow Health Secretary, said the government's plans would do little to improve the NHS.

He said: "The Queen's Speech suggests that Health Ministers are inhabiting a parallel universe where no-one is waiting, vacant NHS posts are filled and everyone is crying out for more bureaucratic changes.

"There are no measures to improve public health and preventive care, to improve staff morale, pay and conditions, or to tackle areas of poor performance in the NHS."