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Warning over health reform plans

The Government's health reforms will spell the end of the NHS and could lead to a US-style system, according to researchers.

The Health and Social Care Bill, currently going through Parliament, will see the NHS replaced by a service in which private companies compete and the Government "finances but does not provide healthcare".

Instead of having a duty to provide a comprehensive health service to patients in England, Health Secretary Andrew Lansley will only have a duty to "act with a view to securing" comprehensive services.

Professor Allyson Pollock, from the Barts and The London School of Medicine, and David Price, senior research fellow at its Centre for Health Sciences, say GP consortia will "not have a duty to provide a comprehensive range of services but only 'such services or facilities as it considers appropriate'."

Under the Government's plans, GP consortia will control 80% of the NHS budget and commission services, including from private companies.

The experts said patients who cannot get access to GP surgeries or consortia services "may have to default to local authorities, which would become the provider of last resort". Furthermore, consortia "will determine which services are part of the health service and which are chargeable, and have been given a general power to charge".

Writing in the British Medical Journal (BMJ), the authors also raise concerns about "referral management centres", which can block hospital referrals for patients, made by GPs.

"These centres are currently rejecting one in eight general practitioner referrals and seem to operate along the lines of 'prior authorisation' arrangements in the United States, whereby doctors are required to obtain approval from a higher authority before making a referral for treatment or investigation."

Health minister Simon Burns said: "This grossly misleading and groundless account is based on pure fabrication and a serious absence of facts. This Government is not - and never will be - in the business of privatising or undermining the NHS.

"We are absolutely committed to a comprehensive national health service, free at the point of use and based on need rather than ability to pay - nothing in our plans changes that."

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