The NHS in England is to undergo a major restructuring in one of the biggest shake-ups since its creation in 1948, the government today announced.

Hospitals are to be moved out of the NHS to create a "vibrant" industry of social enterprises under the proposals.

Also as expected,GPs are to take charge of much of the budget.

The move will lead to the abolition of all strategic health authorities and management bodies known as primary care trusts (PCT's)

The new structure will be held to account by an independent NHS board which would be free from political interference.

Meanwhile, responsibility for public health will be passed to local authorities.

In many ways, the plans outlined in a White Paper go further than expected. The coalition agreement had promised no top-down reorganisations.

But Health Secretary Andrew Lansley said he had decided to go further than first envisaged to rid the health service of bureaucracy.

He said the proposals would be challenging and turn the NHS "upside down" but in doing so help reduce management costs by nearly a half within four years.

He added: "The government's ambition is for health outcomes - and quality services - that are among the best in the world."

The GP paln had long been championed by Mr Lansley - and in recent months the British Medical Association had indicated it was willing to work with the goverment.

The plans mean GPs working in groups will be in charge of a vast collection of hospital, mental health and community services - although specialist services and dentistry will not fall under their remit.

Under the new system, the independent board will sit above as many as 500 consortiums of GPs to set standards and hold the groups to account.

Another key aspect of the changes involves giving patients more information and choice. To achieve this, a new body, HealthWatch, will be set up to compile data on performance, while GP boundaries will be abolished to allow patients to register with any doctor they want.

Mr Lansley also announced he expected all NHS trusts, which run hospitals and mental health units, to get foundation status by 2013.

He also said he would be relaxing the rules which cap the amount of income a trust can make outside the NHS, opening the door to them seeing more private patients.

He said this would allow them to innovate and widen the scope of what they did, but he also admitted it would mean those which were not financially viable could go under.

The government will now consult on its plans before rolling them out over the next three years.

What are your views?

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In it's essence it seems like a rebirth of the original NHS with a few modern tweaks BUT as we all know if there are loop-holes they will be exploited, and of course the great north-south divide will enter at an early stage.
Also with GP fundholding arrangements I can se a lot more eastern european hospitals getting in on the act so dont be surprised if your leg gets fixed in minsk and those gaulstones are dissolved at half-price while you are there!
If I ever move back across the border to England I will worry greatly until I have seen the fine print but as it stands in Wales we are stuck with 3 managers for every doctor and care assistants doing nurses jobs

One of my concerns is Gp's taking control of there budget,i worry they could delay investigations for conditions on the basis of cost or try other treatment rather than the best treatment because its more cost effective
I do think there will be teeting errors but some of the ideas seem good
Looking forward to the full proposal.
I like the new rule about boundries being dropped so you can go to any doctor

My main concern is the GP's taking over funding.....we NEVER see our GP. We always go direct to PCT nurses, consultants,etc... and have direct access to childrens ward. So all I have to do is call them and go. GP's don't know enough about complex needs, and I worry that they would not be in a position to make the right decisions.

(07-13-2010 01:59 PM)zaksmum Wrote:  My main concern is the GP's taking over funding.....we NEVER see our GP. We always go direct to PCT nurses, consultants,etc... and have direct access to childrens ward. So all I have to do is call them and go. GP's don't know enough about complex needs, and I worry that they would not be in a position to make the right decisions.

Yeah, I'm the same here. All prior to getting Maddie seen by a paediatrician I mentioned my concerns to 3 different doctors and was basically fobbed off by them saying that yes, she's delayed but she'll catch up. It was only through seeing a practice nurse for something else that I got the referral. I don't think we've been anywhere near a GP for nearly 3 years now.