The controversial reforms of the NHS have now been cemented in law following the news that the Health and Social Care Bill has been given royal assent.
The resulting Health and Social Care Act (2012) means that GP-led clinical commissioning groups (CCGs) will be set up across England and take charge of much of the NHS budget from PCTs, which are being disbanded.
The reforms have prompted much debate and resistance and have not received support from many of the representative bodies including the BMA, Royal College of GPs, Royal College of Nursing, Royal College of Midwives, Unison, Unite and the Faculty of Public Health.
The Department of Health said the core principles of the Act meant devolved power would allow doctors and nurses to tailor services for their patients, there would be more choice for patients over how they were treated, and bureaucracy in the NHS would be reduced.
In a message to doctors, BMA council chairman, Dr Hamish Meldrum, said: “Despite our best endeavours, the controversial Health and Social Care Bill has now completed its marathon passage through the Westminster Parliament. The passing of this highly flawed Bill worries and saddens me.
“It has been an unnecessary distraction for NHS staff and caused instability and uncertainty on the ground at a time when the health service is trying to meet a considerable financial challenge. Longer term, there is a serious risk of damage to the NHS caused by further development of the market-based philosophy in the NHS.”
However, the legislation was now in place and he added: “It is important that we face that and look ahead to what we, as a profession, can do to limit its more damaging aspects.
“There is still a lot of work to do; a huge amount of secondary legislation has still to be passed and much of that will dictate how doctors work in practice within the reformed NHS. There are still major question marks about the detailed operation of clinical commissioning groups, the NHS Commissioning Board and Monitor's role in the new system of economic regulation.
“As clinicians directly involved in providing care in the NHS, there will still be opportunities to try and temper some of the worst potential consequences of the legislation and keep a health service which, despite this legislation, is still putting patients first in years to come.”
Health secretary Andrew Lansley said: “The Health and Social Care Act will deliver more power to clinicians, it will put patients at the heart of the NHS, and it will reduce the costs of bureaucracy.
“We now have an opportunity to secure clinical leadership to deliver improving quality and outcomes; better results for patients is our objective.”