Page last updated at 20:55 GMT, Monday, 31 January 2011

NHS changes 'will help the poorest fastest' - Lansley

Changes to the way the NHS is run in England will improve "the health of the poorest fastest" and make the institution "fit for the demands of the 21st Century", Health Secretary Andrew Lansley has said.

Opening the second reading debate on the Health and Social Care Bill on 31 January 2011, Mr Lansley said that patients would get more power to choose who they see for treatment.

But he said the changes, which will allow GPs to commission services, were "not a revolution"; instead, they followed on from policies developed under Tony Blair and implemented "incoherently".

The Labour Party "started down the road of extending choice - we will complete that journey", Mr Lansley said.

"While the previous government often talked a good game, we will put these ambitions and these roles into law," he told MPs.

Mr Lansley said: "It was the last Labour government who introduced the concept of payment by results.

"Unfortunately, it tended to be payment by activity, not payment really by results. We will now make it payment by results and really make it happen."

Shadow health Secretary John Healey rejected Mr Lansley's argument: "These are the wrong reforms, for the wrong reasons at the wrong time."

He claimed that the bill was designed to drive "free-market political ideology into the heart of the NHS".

There was a risk that in making referral decisions for patients, doctors would make them "with one eye on their patient and the other eye on their budget and their consortia's bottom line", Mr Healey said.

He concluded: "These changes will break up the NHS, these changes will open up all areas of the NHS to price-cutting competition from private health companies."

Watch part two of the debate here.

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