10:18am UK, Wednesday January 19, 2011
Moves to pass controversial legislation that will lead to more than 150 NHS organisations being scrapped are set to begin.
The Health and Social Care Bill has attracted widespread criticism from unions and policy experts worried that the reforms are "too much too soon".
Under the plans, GPs will be handed the bulk of the £100bn health budget to buy-in services for patients and a new NHS commissioning board will oversee the process.
All of England's 152 primary care trusts (PCTs) will be scrapped alongside 10 strategic health authorities.
PCTs are already being streamlined into "clusters" as part of the transition, with the aim of getting them to work with GP practices and emerging "GP consortia".
The NHS commissioning board will formally establish consortia from April 2012.
But experts have warned that PCT staff are already leaving in droves, leading to concerns about patient services in the interim.
Royal College of Nursing chief executive Dr Peter CarterNurses will have a pivotal role to play in the proposed new NHS structure, and we call on the Government to listen to their concerns.
Leaders of major health unions have also queried how the NHS will implement the changes at the same time as finding £15bn to £20bn in "efficiency savings" - something no major health service has ever managed.
Doctors and nurses' leaders have joined unions in warning that plans to create greater commercial competition between the NHS and private firms are "potentially disastrous".
The Royal College of Nursing's Dr Peter Carter said: "This seminal bill has the potential to transform the NHS.
"However, at the same time as the service is being tasked with saving £20bn, we are concerned that the proposed reforms are too much too soon.
"We will be studying each and every clause of the bill to make sure that the reforms deliver better care for patients.
"Nurses will have a pivotal role to play in the proposed new NHS structure, and we call on the Government to listen to their concerns.
"It is nursing staff who spend the majority of their time directly with patients."
David Cameron has previously met with nurses to hear concerns
Staff and patients will become "victims" of the reforms, according to shadow health secretary John Healey.
"It's about taking off any limits for hospitals to treat private patients in NHS beds, it's about opening up the NMHS in every area to private health companies," he told Sky News.
"And fundamentally it will change the NHS, as well as being very high cost - £3bn which should be spent now on patient care and not on internal management reorganisation."
On Monday, Prime Minister David Cameron strongly defended the Government's reform of public services.
In a keynote speech, he dismissed the idea that the NHS could carry on as it was, supported by small amounts of additional public spending, as a "complete fiction".
He rejected suggestions that the Government was trying to do "too much at once" in pushing through reform.
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