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Government to press ahead with radical NHS reform plans

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Health Secretary Andrew Lansley said a ''very large'' number of people are ''happy'' about change

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The government is expected to confirm it is to push ahead with big structural changes to the NHS in England.
Primary Care Trusts are to be abolished and, from 2013, family doctors will plan hospital care and manage the budgets to pay for it.
Hospitals will also be warned their funding could be docked if patients are forced to share mixed-sex wards.
Meanwhile, doctors and surgeons have given their suggestions on how to save money in an NHS Confederation report.
The government has carried out a public consultation on reform plans and, despite criticism from some doctors, nurses and patients groups, Health Secretary Andrew Lansley is set to indicate that he will press ahead.
GP consortia Mr Lansley told the BBC that, from next April, hospitals would be "held to account" if they failed to get rid of mixed-sex wards.
"We are not going to pay hospitals for providing a sub-standard service," he said. "Patients have a right to expect dignity and privacy and if there is a breach of that, that will be published."
Labour ministers floated the same idea almost two years ago, but mixed-sex wards have proved to be stubbornly persistent.


It is widely expected within the health service that PCTs will get a very small increase in their budgets.
That may not reduce the financial pressure on hospitals, which have seen their payment for treatments frozen this financial year.
If the prices paid to hospitals, known as the tariff, do not keep pace with inflation they will continue to be at the sharp end of finding savings in the NHS.
It would increase the pressure to move some types of care out of hospitals and into the community.
But the main message from Mr Lansley will be that quality must not slip as the reforms to the NHS are pushed through.
Funding for Primary Care Trusts (PCTs) for 2011-12 is also set to be revealed - the last year they will receive a full allocation of money before the reforms begin.
PCTs are local organisations which control 80% of the NHS budget and are responsible for providing services such as hospitals, dentists and opticians.
All 151 in England are set to be scrapped, along with the next tier of organisation, the Strategic Health Authorities - 10 of which operate at a regional level.
In future, the bulk of the NHS budget will be allocated to GPs working in consortia across the country.
But a new report by think tank Civitas says abolishing PCTs outright could damage patient care and is calling for a more "incremental approach" to reform.
James Gubb, from Civitas, said the chaos caused by the sweeping changes could lead to delays in treatment.
"The coalition government needs to stop repeating the mistakes of the past by mandating wholesale structural change," he said.
"Instead, it should seek to build on the best of what currently exists in NHS commissioning while permitting entrepreneurial GPs to take over in areas where the desire is there or PCT-commissioning is failing."
Waste and inefficiency

Start Quote

There are ways both to save money and improve the care we provide”
End Quote Hugo Mascie-Taylor NHS Confederation
Meanwhile, in another report for the NHS Confederation, which represents 95% of organisations that make up the NHS in England, Wales and Northern Ireland, staff have given their ideas to help save money.
For example, many hospitals have different policies on discharging patients which can mean some people stay in longer than is necessary.
Surgeons have also pointed out that scares over infection have led to expensive surgical equipment being thrown away after just one use.
NHS Confederation clinical director Hugo Mascie-Taylor said expert suggestions like these needed to be taken seriously.
"The NHS treats millions of people a year and does so with care and professionalism but there are always ways to improve, to do things better and to reduce waste at the same time."
The NHS in England faces increasing financial pressures, not least the need to make up to £20bn in efficiency savings over the next four years.
On Tuesday, the Commons Health Select Committee said meeting that target would test the NHS to the limit.
The reforms do not affect the health service in Scotland, Wales and Northern Ireland, which are devolved to their national administrations.


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