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NHS changes spelt out in Queen's speech.

As expected, the Queen's Speech included details of the NHS Modernisation Bill, which will scrap the NHS internal market and end GP fundholding, thus sweeping away the most controversial of the changes to the NHS made by the previous government. The Labour party has consistently maintained that the competition for funds created by the internal market has been damaging and that GP fundholding has created an unfair two-tier system of primary care. The Bill also includes a number of other new initiatives notably the following.

  • an independent body, the Commission for Health Improvement, will be established with powers to audit hospitals and send in 'hit squads' to run those it considers to be failing
  • it will 'name and shame' doctors whose performance falls below standard and start disciplinary procedures against them.
  • all parts of the NHS will be given a statutory duty to provide high-quality care.

The government hopes this will restore public confidence in the nation's doctors, following a number of high-profile cases in which standards were not maintained. Conservative criticism of the Bill has so far focused on the alleged increase in bureaucracy. Ann Widdecome, shadow health secretary, said GPs would be turned into pen-pushers. Stephen Thornton of the NHS Confederation said the changes were on a major scale: 'It will take a number of years to get it right'. Rabbi Julia Neuberger, a lay member of the General Medical Council, said she feared that naming and shaming doctors would demoralise the profession without improving matters for patients.

Drug companies are concerned that proposed new powers within the Bill will damage the industry. The present Pharmaceutical Price Regulation Scheme is voluntary but the government proposes compulsory restrictions on how much profit the companies can be make from sales to the NHS. The Association of the British Pharmaceutical Industry says the move would be a 'retrogressive step' leading companies to switch many of their activities to countries which provided a 'more welcoming environment for the research and manufacture of medicines'.

A separate Road Traffic (NHS Charges) Bill will seek to make it easier for hospitals to reclaim the cost of treating accident victims from insurers. Up to £10,000 will be sought per patient, saving the NHS a potential £500 million a year but increasing insurance premiums by an estimated 7#163;10 on average. A Bill to set up the proposed Food Standards Agency was not included in the Queen's Speech, promoting speculation that the government has been having second thoughts on this issue.

Sources: Times 25 November, BBC Online

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