NHS reform plans provoke anger

New plans for patient representation outlined

Campaigners have accused the government of "sneaking out" proposals to abolish community health councils.

The plans are spelt out in the Health and Social Care Bill, published on Wednesday.

The Association of Community Health Councils called Health Minister Alan Milburn "Scrooge", and said thousands of CHC volunteers and staff would have an anxious Christmas.

The CHCs will be replaced by patient forums for each trust. NHS bodies will also have to consult the public on the planning and delivery of local services.

There will also be independent support for patients' complaints and scrutiny of NHS bodies by elected local councillors.

'Sneaked out

Donna Covey, director of ACHEW, said: "It is clear that the Department of Health is far from proud of these proposals. They are being sneaked out under cover of the Christmas recess in the hope that they won't get the scrutiny they deserve."

She added: "The Secretary of State is riding roughshod over the concerns of patients, professional bodies and his own backbenchers on this issue."

The Secretary of State is riding roughshod over the concerns of patients, professional bodies and his own backbenchers on this issue

Donna Covey
ACHEW

Ms Covey said there were concerns about the independence of the proposed alternatives to CHCs, their lack of integration and the absence of a national voice for patients.'

She added: "If the Secretary of State pushes ahead with the bill in its current form patients will lose a respected, effective, independent health watchdog and in its place they will get a system which is more fragmented, less independent and which has no national voice.'

Builds on Plan

The Health and Social Care Bill builds on proposals set out in the summer's NHS Plan.

The bill also sets out proposals for free nursing care for 35,000 people in nursing and residential homes, who will also be able to take out council loans to avoid selling their houses to pay for residential care.

Health authorities will take over power from the central NHS tribunal system to remove and suspend GPs.

And they will have to hold a register of all the GPs in the area, with only those on the list able to practise, including freelance locum doctors who are not currently required to be listed.

There will also be an annual system of checks on primary care services provided during the day in surgeries, and in the evenings and weekends by out-of-hours services.

Health minister John Denham said: "This Bill will put patients at the very heart of the NHS, giving them a voice at every level, and ensuring that they are involved in decisions made about their local health services.

Doctors' concerns

Doctors' leaders said they had concerns about the abolition of CHCs, and wanted assurances from the government that the councils' role in representing the public's interest and about patient confidentiality and advocacy, scrutiny and inspection would not be lost.

Dr John Chisholm, chairman of the British Medical Association GP Committee said: "Much of the Bill derives from the NHS Plan for England, but some clauses give us cause for concern on behalf of patients.

"The Secretary of State for Health will have additional powers to authorise sharing of information in the health service."

He said the BMA would be scrutinising new clauses which could aid the fast transfer of patient data to ensure there were ethical standards and adequate confidentiality arrangements.

The NHS Confederation praised measure in the bill aimed at modernising primary care, extending prescribing rights to nurses and other staff and the creation of care trusts.

Stephen Thornton, chief executive of the confederation, said the initiatives on patient and public involvement should improve, rather than fragment the existing structures.