NHS Reforms

Asked, what the Prime Minister (PM) thought of the Deputy Prime Minister’s (DPM) letter to Lib Dem peers and whether he was consulted on it, the Prime Minister’s Spokesperson (PMS) said he was aware of the letter and he was happy to provide further reassurance on the issues covered.

Asked whether the PM and Minister for Health Simon Burns agree, the PMS said we had made significant changes to the Health and Social Care Bill following the listening exercise and didn’t see the need for significant changes. The PMS added there were a number of areas where further reassurance was required and that would be addressed.

Asked whether these changes were insignificant’, the PMS said there were a number of issues raised in the letter that relate to competition and how it operated in the health service. The PMS said the objective of reform was to put patients at the heart of the NHS. The PMS made clear the NHS would not be treated as a private industry and that commissioning groups would decide where competition was appropriate to drive quality.

Asked if the Government would oppose the amendments, the PMS said the letter did not set out specific amendments but no doubt there would be amendments. If the Government needed to provide further reassurance it was happy to do so.

Asked when the PM approved the letter, the PMS said the letter had been discussed and discussions of these issues had been going on for sometime.

Asked what the background of the letter was, the PMS said he was not getting into process, but that it was written by the DPM and Shirley Williams, and the PM knew about the letter and its content.

Asked if the PM wanted Conservative members to back the amendments, the PMS said that whipping arrangements were not yet confirmed, but the Government wanted MPs to back the Bill.

Asked if the PM agreed with the DPM that in its current form the Bill provided an American-style system within the NHS, the PMS said we were not proposing a US-style healthcare system in this country and the Bill would not create one.

Put that this was clearly the concern of the DPM, the PMS said he did not believe the letter implied that and the Bill did not propose a US-style system.

Asked if the PM understood DPM’s concerns, the PMS said he understood that there had been a huge amount of debate and scrutiny of the proposals.

Asked why there was still debate around the content of the Bill despite the listening exercise, the PMS said the current debate was about clarifying the issue of competition and making clear the Government was not privatising the NHS.

Asked if legislation subject to so many changes can be good legislation, the DPM said the Bill was getting a great deal of scrutiny, which was a good thing and it was important to get it right.

Asked if these proposals would keep the amount of competition in the NHS the same or reduce it, the PMS said over time we wanted patients to be able to exercise more choice, and GPs to be able to do that on their behalf.

Asked if the DPM required reassurance, the PMS said that was a question for the DPM to answer but added that the DPM had made clear his support for the reforms on many occasions.

Asked if this would be seen as a cave in by Tory backbenchers, the PMS said the government was pushing ahead with the reforms it has set out.

Asked if the Bill would decrease the amount of competition in the health service, the PMS said the level of competition was in the hands of the commissioning groups.

Asked if the PM would be happy if there was an increase in the role of competition, the PMS said he wanted to see an NHS acting in the best interest of its patients, and if commissioning groups thought that going to another provider would improve patient care they should do that.

Asked if the Government would be increasing the number of providers, the PMS said the test was not the number of providers but what was in the best interest of patients, and that has always been the case.

Budget

Asked about changes to Council Tax bands, the PMS said that there was a lot of budget speculation and he would not be drawn on it.