The government yesterday signalled its determination to press ahead with a shake-up of the NHS and social services in the face of criticism from sections of the medical profession and community health councils. The health secretary, Alan Milburn, published the health and social care bill to implement parts of the NHS plan, which he and Tony Blair unveiled last summer.
The bill proposes granting nurses and pharmacists a wider medical role (notably in prescribing drugs) and tackling hospital "bed blocking" by improving ties with social services departments. Controversially, Mr Milburn also wants to see local community health councils replaced with patients' forums inside every NHS trust.
The bill proposes to empower health authorities to suspend sex abusers in the health service without going through the current protracted procedures. This follows an announcement of an inquiry into the case of a GP who abused patients over eight years.
Locum services will also be more tightly regulated, further examples of what Alan Enthoven, the professor who created the Tories' NHS "internal market" policy, calls a doomed attempt to modernise "a public sector monopoly".
The reforms will be hard fought up to the election. Contrary to some reports ministers have not drawn back from their controversial proposal to prevent hospital doctors from taking on part time private practice until seven years after they qualify. The rule change can be made within the existing legislative framework.
The device is intended to protect the NHS's investment in training doctors at public expense.
The bill represents Labour's foray into the partnership with the private sector in its provision for private funds to be used to help rebuild inner city GP's surgeries.
There are fears that ministers might withdraw from proposals to create primary care trusts. The trusts would allow health authorities to create partnerships with social services departments to improve the situation of elderly people who "block" hospital beds when they need only personal care.
The bill will implement Mr Milburn's controversial plan to give elderly people in homes free nursing care, worth up to £5,000 a year, while making them pay for personal care.
Mr Milburn's bill also provides cash incentives for the more innovative hospital trusts.
In a paper for the Adam Smith think tank Prof Enthoven called this idea "childish, almost embarrassing".
Useful links
www.parliament.the-stationery-office.co.uk
The bill in full
