Hewitt's apology aims to calm NHS nerves over privatisation plans

Guardian, Saturday November 12, 2005
John Carvel, social affairs editor

· Minister moves to head off revolt over reforms
· Hints that white paper may be watered down

Patricia Hewitt, the health secretary, moved to calm the nerves
of jittery NHS doctors and managers yesterday with assurances
that she was not preparing extensive privatisation of medical
services outside hospitals.

In a speech to community health chiefs in Harrogate she
apologised for publishing plans in July to force primary care
trusts to contract out all district nursing, family planning
clinics and other local health services.

She also hinted that a white paper in January may water down
Tony Blair's ambition to create competition between NHS GPs and
private clinics in every area of England.

Her attempt to take the heat out of criticism of NHS reforms
came before a round of private meetings with Labour backbenchers
next week, when she will try to stop health policy joining
education and the detention of terrorists as a focus of party
dissent.

She also needed to take the steam out of opposition in the
medical professions after a febrile fortnight in which the Royal
College of Nursing began a legal action against lack of
consultation and doctors' leaders took umbrage at her plans to
give nurses full prescribing rights.

Ms Hewitt's apology came in a speech to the NHS Alliance's
annual conference.

"I know many of you were unhappy about what we said at the end
of July about the future of services that primary care trusts
correctly provide. I am very sorry that many staff have been
caused anxiety ... Clearly we were too presciptive," she said.

About 250,000 district nurses, health visitors and other staff
delivering clinical services would continue to be employed
directly by the NHS unless local trusts decided otherwise after
full local consultation, she said.

The white paper is expected to include plans to allow
"entrepreneurial GPs and nurse practitioners" to expand into
other areas to offer improved services to patients. But Ms
Hewitt said that this did not mean the end of NHS provision "or
the NHS becoming purely a funder and commissioner of services.

"I have no doubt at all that - in primary and community health
services, as in acute hospitals - NHS providers will continue to
flourish," she said.

In a briefing for journalists, Ms Hewitt said private firms and
other alternative providers might need to be brought in to offer
improved services in the poorest areas where patients often have
the worst care. She implied that the white paper might introduce
a competitive market in under-doctored areas, but not elsewhere.

An official said last night: "Where the NHS is doing an
excellent job, we will not interfere. But where it is not we may
have to do more to help patients."

In another retreat on the radical agenda, Thames Valley health
authority postponed plans to contract out the commissioning of
primary care in Oxfordshire - viewed across the NHS as the most
extreme example of Blairite health reform.

Nick Relph, the chief executive, had been preparing to advertise
in the EU's official journal next month for companies to tender
for the management of the county's community health services,
including GPs and district nurses. Likely bidders included
United Health, a US healthcare corporation whose international
president is Simon Stephens, Mr Blair's former health adviser.
But Mr Relph withdrew the plan after Lord Warner, the health
minister, told MPs: "I am not an advocate for this." A new
primary care trust will decide how services should be
reorganised when it is appointed in June.
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