Hospitals will become more accountable under reforms

---

Hospitals would become more accountable to doctors under Coalition reforms, according to the newly-appointed chair of the NHS Commissioning Board.

Addressing the House of Commons health committee, Professor Malcolm Grant described reforms as introducing "a fundamental change in responsibility and accountability" in the NHS.

However, he denied the bill would freeze out patients' concerns over their treatment, or the general public’s opinions on the health service.

"We need to make sure that CCGs (clinical commission groups) – these are the GPs who are being empowered – have the responsibility to take these decisions. If they are unsatisfied with what happens in a hospital, to complain about it and not just to a Secretary of State who no longer has this responsibility, nor to the commissioning board which has given them the responsibility – but to the hospital to get it sorted. And if it is not sorted, to use their commissioning power to ensure that it is.

"That seems to me to be a fundamental change in responsibility and accountability under the bill."

He added: "I know am due for a shock a day in this job….what I would like to ensure as we develop this is that we get away from developing the NHS from shock-shock and crisis to crisis.

"That there is a more measured view which is to do with one, two three year improvements in the quality of health and patient care in this country. That has to be the long-term strategic aim and we can't do that by passing up blame through the system."

Public tension

Professor Grant denied the reforms would be a quick fix to systemic problems in the NHS and described the Health and Social Care Bill as “a long-term process”.

“I acknowledge all of those tensions and I think that their resolution is going to be immensely difficult. This is not going to end up with a perfect health system… this is a long-term process."

He encouraged managing bodies of the NHS to work closer together if the service was going to be improved.

"First of all the relationship between public health and the board, I think is absolutely fundamental if you want to deliver a set of health outcomes for the nation as a whole because those health outcomes are very much related to health inequalities….that is going to require coordinated action which is impossible to prescribe in legislation. It require the bodies to work more closely together."

However, he said a little over a fifth of the NHS' annual £110bn budget would be spent on GP commissioning.

"A significant amount of the board’s budget, around £20bn will go into commissioning primary care.

"I hope that I have said that there is a tension….the simple answer is to say that it is back to the clinical commissioning groups to develop their own approach to integration and to ensure that patient choice is exercised from appropriate guidance from the GP."

He added: "I suppose my natural inclination is to let people do what they are going to do. You and I can’t run a GP practice from Westminster."