In spite of a last minute plea by the BMA and a motion calling for controversial health reforms to be scrapped the Health and Social Care Bill last night cleared its final hurdle in the House of Lords. It is expected to receive the Royal Assent later today. The legislation would abolish Strategic Health Authorities and Primary Care Trusts and give much greater control over care budgets and commissioning decisions to GPs and other health professionals.
It also establishes Clinical Commissioning Groups (CCGs) – organisations of GPs and other healthworkers who will determine and purchase health care at local level – as legal entities from April next year.
However Labour have forced a Commons debate later today on whether MPs can consider planned NHS changes for a final time before an assessment of the potential risks to the health service is published.
The government has agreed to a series of changes to the bill and want it to become law as soon as possible.
Last night peers considered a series of amendments to the bill, including on the registration of healthcare support workers and the functions of the body due to replace the Health Protection Agency.
But they rejected a motion by Labour peer Baroness Thornton calling for the bill to be dropped by 269 to 174 votes.
Her motion that the bill did "not command the support" of patients, NHS workers or the public and would lead to the "fragmentation and marketisation" of the health service - was defeated by 95 votes.
Lord Greaves was the only Liberal Democrat rebel who voted with Labour on Monday in their bid to block the bill's passage. Some 73 Lib Dem peers voted against the amendment, along with 170 Conservatives.
MPs will today consider amendments to the bill agreed by the Lords on - the final stage in its passage - but only after a 90-minute emergency debate on the plans.
The NHS Alliance and the National Association of Primary Care (NAPC) which have come together as the Clinical Commissioning Coalition (CCC) and represent GPs and other primary care workers says it is vital that GPs take control of the implementation of the clinical commissioning reforms and are not “the passive recipients of a centrally driven implementation programme”.
Dr Michael Dixon, a senior member of the CCC said: “With each reform, there have been forces of inertia, vested interests and hard line opponents undermining and stalling developments, willing new systems to fail. We are not going to let that happen – not this time! This is our time, our one chance, to seriously make the difference. The balance will shift and will do so irrevocably, if we move forward with this opportunity.
“From now on, commissioning, led by frontline clinicians and patients, will be the order of the day, and local clinical leadership will no longer be ignored or neutralised.”
Dr Charles Alessi, another CCC representative, added: “This is the coming of age for primary care in general, and specifically for family doctors and their patients. Let us work in partnership to serve our local communities.”