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7 June 2011
Last updated at 10:18 ET
David Cameron has outlined "real changes" to controversial plans for NHS reforms in England, following criticism from health service professionals.
Hospital doctors and nurses will be involved in care commissioning, as well as GPs, and regulators will have a duty to "support integration" of services.
It comes ahead of the outcome of a consultation exercise due next week.
Labour leader Ed Miliband earlier said the plans were "botched" and would divert money from patient care.
In a speech, Mr Cameron said the government had listened to concerns about the planned reforms - which would give GPs more commissioning powers, increase competition in the NHS and abolish primary care trusts - expressed during a recent "listening exercise".
'Listened and engaged' As a result, he said he would support a number of important changes to the proposals:
The prime minister also confirmed that the coalition will retain existing targets such as the 18-week limit on waiting lists in England and the four-hour waiting limit in A&E but there will be increased focus on the outcomes of treatment - such as hospital readmission rates.
Mr Cameron said ministers had "learned a lot about how to make our plans better" during the two-month consultation.
"We have listened and engaged and not just heard what people have said but we are going to reflect it in what we are going to do. There are real changes being made to these health reforms to reflect the concerns of patients, doctors and nurses so we get that right."
As part of efforts to reassure the public about the changes, he also set out "five guarantees" which he said would protect the "precious idea" underpinning the NHS.
He said the NHS would remain a universal service, changes would improve "efficient and integrated care" not hinder it, hospital waiting times would be "kept low", NHS spending would be increased every year and there would be no privatisation or cherry-picking by private providers.
"We will stick by our core principle of an NHS that is more efficient, more transparent and more diverse... But I will make sure at all times that any of the changes we make to the NHS will always be consistent with upholding these five guarantees.
"There can be no compromise on this. It is what patients expect. It is what doctors and nurses want. And it is what this government is determined to deliver."
'Panic move' Plans to modernise the NHS have caused tension between Conservative and Lib Dem partners and ministers have already conceded there would be substantial changes to the Health and Social Care Bill as a result of the consultation.
The BBC News Channel's chief political correspondent Laura Kuenssberg said these were very real changes to the original plans drawn up by Health Secretary Andrew Lansley and would raise concerns among some Tory MPs about whether the system was really being simplified and costs driven down.
Continue reading the main story Analysis
The prime minister has deliberately chosen to make the furore over the NHS bill an issue of trust.
No longer is it simply about the nuts and bolts of NHS reform.
Instead the prime minister has issued five "guarantees" on the future of the service for which he says he can be held "personally accountable".
The hope is that by issuing this sort of personal pledge he can overcome the widespread doubts among health professionals and the electorate about the reforms.
His problem is that however convinced voters may be by Mr Cameron's support for the NHS, all the evidence suggests they still harbour a large slab of scepticism about his party's attitude towards the health service.
Labour, and the doctors' body the British Medical Association, have called for the legislation to be scrapped entirely.
At a press conference on Tuesday, Labour Ed Miliband said the proposed NHS shake-up would divert hundreds of millions of pounds away from patient care, at a time the NHS was being asked to find £20bn savings.
Mr Miliband said: "I think the reason why the prime minister is in such a panic over the NHS is because he knows that this is total breach of the promises he made at the election. He promised no top-down reorganisations, he went to nurses' conferences and promised that and now he's doing the opposite... in the most cack-handed way."
But speaking in the Commons, Mr Lansley said the reforms would help "improve performance" across the board in the NHS.
The BBC understands the NHS Future Forum report will be delivered to Cabinet either next Monday or Tuesday.
Ministers could decide to delay the Health and Social Care bill, which has been on hold pending the outcome of the consultation, further by sending it back to its committee stage in the Commons for further scrutiny.
The Department of Health says 8,000 people took part in 250 events during the consultation, 2,400 public comments were submitted via a government website and 970 comments submitted privately.
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Hospital doctors and nurses will be involved in care commissioning, as well as GPs, and regulators will have a duty to "support integration" of services.
It comes ahead of the outcome of a consultation exercise due next week.
Labour leader Ed Miliband earlier said the plans were "botched" and would divert money from patient care.
In a speech, Mr Cameron said the government had listened to concerns about the planned reforms - which would give GPs more commissioning powers, increase competition in the NHS and abolish primary care trusts - expressed during a recent "listening exercise".
'Listened and engaged' As a result, he said he would support a number of important changes to the proposals:
- Doctors and nurses will be involved in new consortia planning and buying care, not just GPs
- These groups will only take responsibility when they are ready not by April 2013 as previously envisaged
- New "clinical senates" consisting of senior medical profssionals will oversee integration of NHS services across local areas
- NHS watchdog, Monitor, will have a duty to promote integration of care across an area
- Greater competition will only be introduced when it benefits patient care and choice
There are real changes being made to these health reforms to reflect the concerns of patients, doctors and nurses so we get that right”
End Quote
David Cameron
The prime minister also confirmed that the coalition will retain existing targets such as the 18-week limit on waiting lists in England and the four-hour waiting limit in A&E but there will be increased focus on the outcomes of treatment - such as hospital readmission rates.
Mr Cameron said ministers had "learned a lot about how to make our plans better" during the two-month consultation.
"We have listened and engaged and not just heard what people have said but we are going to reflect it in what we are going to do. There are real changes being made to these health reforms to reflect the concerns of patients, doctors and nurses so we get that right."
As part of efforts to reassure the public about the changes, he also set out "five guarantees" which he said would protect the "precious idea" underpinning the NHS.
He said the NHS would remain a universal service, changes would improve "efficient and integrated care" not hinder it, hospital waiting times would be "kept low", NHS spending would be increased every year and there would be no privatisation or cherry-picking by private providers.
"We will stick by our core principle of an NHS that is more efficient, more transparent and more diverse... But I will make sure at all times that any of the changes we make to the NHS will always be consistent with upholding these five guarantees.
"There can be no compromise on this. It is what patients expect. It is what doctors and nurses want. And it is what this government is determined to deliver."
'Panic move' Plans to modernise the NHS have caused tension between Conservative and Lib Dem partners and ministers have already conceded there would be substantial changes to the Health and Social Care Bill as a result of the consultation.
The BBC News Channel's chief political correspondent Laura Kuenssberg said these were very real changes to the original plans drawn up by Health Secretary Andrew Lansley and would raise concerns among some Tory MPs about whether the system was really being simplified and costs driven down.
Continue reading the main story Analysis
The prime minister has deliberately chosen to make the furore over the NHS bill an issue of trust.
No longer is it simply about the nuts and bolts of NHS reform.
Instead the prime minister has issued five "guarantees" on the future of the service for which he says he can be held "personally accountable".
The hope is that by issuing this sort of personal pledge he can overcome the widespread doubts among health professionals and the electorate about the reforms.
His problem is that however convinced voters may be by Mr Cameron's support for the NHS, all the evidence suggests they still harbour a large slab of scepticism about his party's attitude towards the health service.
Labour, and the doctors' body the British Medical Association, have called for the legislation to be scrapped entirely.
At a press conference on Tuesday, Labour Ed Miliband said the proposed NHS shake-up would divert hundreds of millions of pounds away from patient care, at a time the NHS was being asked to find £20bn savings.
Mr Miliband said: "I think the reason why the prime minister is in such a panic over the NHS is because he knows that this is total breach of the promises he made at the election. He promised no top-down reorganisations, he went to nurses' conferences and promised that and now he's doing the opposite... in the most cack-handed way."
But speaking in the Commons, Mr Lansley said the reforms would help "improve performance" across the board in the NHS.
The BBC understands the NHS Future Forum report will be delivered to Cabinet either next Monday or Tuesday.
Ministers could decide to delay the Health and Social Care bill, which has been on hold pending the outcome of the consultation, further by sending it back to its committee stage in the Commons for further scrutiny.
The Department of Health says 8,000 people took part in 250 events during the consultation, 2,400 public comments were submitted via a government website and 970 comments submitted privately.
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