Government sets out NHS Bill changes

The Department of Health has published 363 proposed changes to the legislation, which implement the government’s response to the NHS Future Forum’s consultation on the reforms.

After the listening exercise, the Bill was recommitted to the House of Commons in June and is due to have its report stage and third reading on September 6 and 7.

The government’s amendments to the Bill include changes to ensure continued NHS services if providers fail when greater competition is introduced.

Among the main changes is the provision for NHS regulator Monitor to begin ‘intervening proactively where a provider of NHS services gets into financial difficulty and with the aim of supporting recovery and preventing providers becoming unsustainable’. Previously, the plans proposed only having these interventions in parts of the NHS system that had been designated as needing additional regulation.
Outlining the change, the briefing note on the government amendments said that where a provider gets into difficulty, Monitor can appoint agents to work with health care commissioners in drawing up plans to secure continued NHS services.

Monitor will be required to set up effective mechanisms to provide financial assistance to these special administrators, in line with the service requirements determined by commissioners.

The government has also outlined changes to the specific failure regime for foundation trust hospitals. Although these will continue to be based on the existing 2009 Health Act, the health secretary will no longer be able to take control of any failing trusts by de-authorising them. Instead, Monitor would trigger the continuity of service regime.

The changes follow the NHS Future Forum consultation on the reform plans. This led to the government accepting a number of changes to the initial plans, including scrapping of the April 2013 deadline for the creation of the GP commissioning groups, and widening their membership to form clinical commissioning groups, with a wider range of health professionals such as nurses and specialists.

Health Secretary Andrew Lansley also said there would also be a phased approach to the introduction of the ‘any qualified provider’ provisions that will increase competition in the NHS.