Denmark has imposed the world’s first “fat tax” in a drive to slim its population and cut heart disease.The move may increase pressure for a similar tax in the UK, which suffers from the highest levels of obesity in Europe.

Starting from this Saturday, Danes will pay an extra 30p on each pack of butter, 8p on a pack of crisps, and an extra 13p on a pound of mince, as a result of the tax.

The tax is expected to raise about £140 million, and cut consumption of saturated fat by close to 10pc, and butter consumption by 15pc.

“It’s the first ever fat-tax,” said Mike Rayner, Director of Oxford University’s Health Promotion Research Group, who has long campaigned for taxes on unhealthy foods.

“It’s very interesting. We haven’t had any practical examples before. Now we will be able to see the effects for real.” The tax will be levied at 2.5 per Kg of saturated fat and will be levied at the point of sale from wholesalers to retailers.

Less than 10pc of Danes are clinically obese, putting them slightly below the European average.

But researchers at Denmark’s Institute for Food and Economic estimate that close to 4pc of the country’s premature deaths are a result of excess consumption of saturated fats.

For Britain, where more than 20pc of the population is obese, the number will be considerably higher.

A 2007 study by Mr Rayner’s group concluded that a combination of taxes on healthy foods and tax breaks on fruit and vegetables could save 3,200 lives a year in the UK.

Health Minister Andrew Lansley has up until now resisted calls for taxes on unhealthy foods, but Mr Rayner said they were the only credible way to combat Britain’s obesity problem.

“I think we’re going to have them in Britain whether Mr Lansley wants them or not, because the obesity crisis in the UK is such that we need to take more action.

From: http://www.telegraph.co.uk/Denmark-taxes-fatty-products

Foreign doctors who cannot speak English are to be banned from working in NHS hospitals and clinics, the Health Secretary will announce today.The NHS will introduce mandatory language tests for doctors moving to Britain after training elsewhere in the European Union.

The decision follows a series of cases in which patients have died or suffered poor care as a result of doctors speaking sub-standard English.

The issue was brought to national attention three years ago when Dr Daniel Ubani, a German-trained GP on his first out-of-hours shift in Britain, killed David Gray, 70, by giving him 10 times the normal dose of diamorphine.

In his speech to the Conservative Party conference today, Andrew Lansley will say that the Medical Act will be amended so that doctors must speak good English to practise in Britain.

“I am determined that doctors who come from overseas to work here in our NHS must not only have the right qualifications, but also the language skills to practise here,” the Health Secretary is expected to say. “We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients. This is not about discriminating; we’ve always appreciated how much overseas doctors and nurses give to our NHS. It is simply about our absolute commitment to put patients’ safety first.”

There are more than 88,000 foreign-trained doctors registered to work in Britain, including 22,758 from Europe. They account for almost a third of the total.

Under the proposals, local NHS trusts would have a duty to check the language skills of foreign-trained doctors before they can be employed. In addition, the General Medical Council would be given powers to take action against doctors when there were concerns about their ability to speak English. At present, only doctors from outside the European Economic Area are routinely scrutinised for their language skills before being registered by the GMC.

This means that doctors from Canada or Australia are routinely tested for their language skills while those from countries such as Poland and France are not.

It had previously been thought that European Union laws ensuring the freedom of movement of labour prevented language testing. However, the European Commission has recently stated that the language tests would be legal.

Dr Ubani, who admitted he had never heard of the drug he gave to Mr Gray, was struck off by the GMC in June last year but still practises in Germany. His poor English meant he was refused work by the NHS in West Yorkshire but was accepted in Cornwall and Camb-ridgeshire, where he saw Mr Gray.

Since the case, the GMC and other NHS leaders have repeatedly warned that some foreign doctors’ language skills are so poor that patients are being put at risk.

Compulsory language tests for foreign doctors will raise concerns that the NHS could be left short-staffed, such is its reliance on overseas medics. Ministers believe that the majority will reach the necessary standard of English.

Mr Lansley will today deliver a robust defence of the Government’s health policy, saying that money is being diverted from cutting bureaucracy to front-line services.

“Unlike Labour, we will make sure that every penny of our investment goes right to the patients who matter, not the huge Labour bureaucracy which we inherited,” he will say. “And all that is why, since the election, we now have 1,500 more doctors and 5,000 fewer managers in the NHS.”

He will also claim that hospital infection rates have fallen and the number of people being treated in mixed-sex wards has fallen by more than 90 per cent over the past eight months.

From: http://www.telegraph.co.uk/Conservative-Party-Conference-2011-doctors-from-overseas-must-speak-English-or-be-banned

The nanny state banned in England cigarette vending machines over the weekend.The Department of Health said the ban had been introduced to prevent under-age sales to children and to support adults who were trying to quit.

The rest of the UK is expected to implement a similar ban next year.

Some pub landlords say it is a further threat to a livelihood that has already been damaged by the smoking ban.

But Cancer Research and the British Heart Foundation have welcomed the move.

According to the Department of Health, nearly all adult smokers started smoking before they turned 18.  Of the children who regularly smoke, 11% buy their cigarettes from vending machines.

It is also estimated that 35 million cigarettes are sold illegally through vending machines to children every year.

Under the new rules, pub landlords will still be able to sell cigarettes from behind the bar but they must ensure all tobacco advertising on vending machines is removed. Any person found guilty of displaying cigarette adverts on a vending machine could face imprisonment for up to six months, a fine of £5,000, or both.

Health Secretary Andrew Lansley said smoking was “one of the biggest and most stubborn challenges in public health”, with more than eight million people in England still smoking, causing more than 80,000 deaths each year.

He said: “Cigarette vending machines are often unsupervised, making it easy for children to purchase cigarettes from them.

“The ban on cigarette sales from vending machines will protect children by making cigarettes less accessible to them – we want to do everything we can to encourage young people not to start smoking in the first place.”

Jo Butcher, the National Children’s Bureau’s programme director of health and wellbeing, welcomed the ban and said a person’s lifetime smoking or non-smoking behaviour was “heavily influenced” by decisions in their adolescence.

“Children and young people tell us that external influences make it even more difficult for them to choose healthier lifestyles.

“It’s essential that we create environments that improve health and tobacco legislation is an important part of public health protection and promotion,” she said.
Protection

Charities have also welcomed the ban.

Betty McBride, director of policy and communications at the British Heart Foundation, said thousands of children at risk of this “deadly addiction” regularly got tobacco from vending machines, “which conveniently don’t ask them to prove their age”.

“These children are often blissfully unaware of the damage smoking does to their health and, by the time they realise, they’re hooked.

“Scrapping these machines cuts off an easy source of tobacco for existing young smokers and makes it harder for a new generation to start.

“We’re encouraging landlords to remove machines completely now so they – and any left-over branding – don’t act as dusty old adverts for tobacco,” she said.

Eileen Streets, director of tobacco control at the Roy Castle Lung Cancer Foundation, said she hoped the ban would play a “significant part in stopping many children becoming the next generation of lung cancer victims”.

Jean King, of Cancer Research UK, added: “Tobacco kills half of all long-term users and is responsible for one in four cancer deaths.

“Cancer Research UK is determined to protect children from tobacco marketing and through our Out of Sight Out of Mind campaign we are continuing to work for legislation to introduce plain packaging for cigarettes.”

But the British Beer and Pub Association described the ban as “an unnecessary measure”.

A spokesman said the machines were there for the convenience of adult customers, and that the association did not believe they played a role in childhood smoking.

Although cigarettes can be sold by bar staff, the spokesman said many pubs would not opt to introduce that, as it raised issues about having a “high-value” item behind the bar and interfered with serving drinks.

Other measures to protect young people from the dangers of smoking are also on the way.

In April 2012, large retailers in England and Scotland will have to get rid of all tobacco displays. Small shops will be expected to comply from April 2015.

Wales and Northern Ireland plan to implement similar regulations.

The government is also due to begin a public consultation before the end of the year on whether to introduce plain packaging for cigarettes in order to lessen their marketing appeal to young people, help make health warnings more effective and help reduce the number of smokers.

From: http://www.bbc.co.uk/news/uk-15132529

Dismantling Labour’s disastrous £12 billion NHS IT programme may cost taxpayers more than keeping it going.Ministers announced on Thursday that they will speed up the scrapping of the National Programme for IT (NPfIT)  after a review concluded “there can be no confidence that the programme has delivered or can be delivered as originally conceived”.

It confirmed earlier reports that the central part of the scheme, allowing NHS staff across England to access any patient’s details, was unworkable while costs had increases and deadlines were missed.

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”

From: http://www.telegraph.co.uk/Dismantling-NHS-computer-scheme-could-cost-more-money

Patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes the Health Secretary warns.Andrew Lansley says he has been contacted by 22 health service trusts which claim their “clinical and financial stability” is being undermined by the costs of the contracts, which the Labour government used extensively to fund public sector projects.

The trusts in jeopardy include Barts and the London, Oxford Radcliffe, North Bristol, St Helens and Knowsley, and Portsmouth.

Between them the trusts run more than 60 hospitals which care for 12 million patients.

There is already evidence that waiting lists for non–urgent operations have begun to rise as hospitals delay treatment to save money. Adding to this are growing fears over the impact of the financial crisis on care this winter.

Under the PFI deals, a private contractor builds a hospital or school. It owns the building for up to 35 years, and during this period the public sector must pay interest and repay the cost of construction, as well as paying the contractor to maintain the building.

However, the total cost of the deals is often far more than the value of the assets. As a result, Mr Lansley says, the 22 trusts “cannot afford” to pay for their schemes, which in total are worth more than £5.4billion, because the required payments have risen sharply in the wake of the recession.

Mr Lansley said: “Over the last year, we’ve been working to expose the mess Labour left us with, and the truth is that some hospitals have been landed with PFI deals they simply cannot afford.

“Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse. Tough solutions may be needed for these problems, but we’ll help the NHS overcome them. We will not make the sick pay for Labour’s debt crisis.”

He said hospitals would not be allowed to collapse financially.

“There are many hospitals that are well run, do not have a legacy of debt and do have projects which are perfectly sustainable. My point is that we have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future. We can only do that if we work closely with them,” he said.

“This is about making very clear that we are not only working on unsustainable PFIs, but also working with legacy debt that the NHS has been left with, working on the IT programmes which were on an unsustainable scale of contractual commitments that didn’t meet the need of the NHS’s customers.

“Across the board, we have to tackle Labour’s legacy of poor value formoney and debt.”

Over the next few weeks, Department of Health officials and executives at the 22 trusts will develop detailed plans for dealing with the crisis. Their proposals are expected to include significant cost–cutting and the renegotiation of PFI contracts.

Money will also be moved from NHS trusts that are in better financial shape to cover the debt costs at those that are struggling. However, officials are braced for the need to use Whitehall funds to bail out some hospitals.

Among the trusts which have contacted Mr Lansley to inform him of their severe financial problems are several London institutions, including South London Healthcare, Barking, Havering and Redbridge, and North Middlesex.

Outside the capital, other trusts to have approached the health department include Wye Valley, Worcester Acute Hospitals, Mid Yorkshire, and Walsall.

After the general election last year, Mr Lansley ordered officials to establish why some NHS hospitals were under–performing. The health department is assessing the financial position of every hospital. It is understood that the PFI costs have emerged as a leading factor in poor patient care in some areas.

The Health Secretary decided to disclose the list of hospitals in difficulty and is expected to announce the rescue plans for each trust next month.

Taxpayers are having to pay more than £200 billion for schools, hospitals and other projects whose capital value is little more than £50 billion.

In one example, a hospital in Bromley, south east London, will ultimately cost the NHS £1.2 billion, more than 10 times what it is worth. Another hospital was charged £52,000 for maintenance that cost £750. The annual cost of the schemes is almost £400 for each household.

The public payments for PFI deals are typically linked to inflation and therefore the cost to taxpayers has increased by up to a third since the beginning of the credit crisis, according to the National Audit Office. Last month, MPs on the Treasury select committee effectively called for a moratorium on new PFI projects, which it said were “like a drug” as the costs were not apparent at the outset.

George Osborne, the Chancellor, has tightened the rules on the deals.

Earlier this year, John Healey, the shadow health secretary, admitted in an interview that Labour ministers had failed when negotiating the multi–million pound schemes for hospitals.

“There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts at the outset,” he said.

Companies who run PFI schemes boast profit margins of up to 71 per cent on the projects, but have come under growing pressure from MPs and ministers to return some of their “windfall profits”.

From: http://www.telegraph.co.uk/NHS-hospitals-crippled-by-PFI-scheme

Health secretary Andrew Lansley’s decision to launch groups designed to champion views of patients leads to complaints.
Andrew Lansley’s plans to put the patient at the heart of the NHS have been labelled as “confusing, vague and insulting”.

The health secretary pushed ahead with HealthWatch, the new body to champion patients’ views, despite ministers being forced to apologise and withdraw a consultation on the new watchdog. Ministers had conceded that their original plans had been conceived in haste and without proper consultation.

But Lansley announced that 75 local HealthWatch groups were in place. HealthWatch is supposed to replace local patient involvement networks, known as LINks, in 2012 – bringing “real local democratic accountability and legitimacy” to the NHS “for the first time in 40 years”.

Malcolm Alexander, chair of the National Association of Local Involvement Networks Members, said that, instead of increasing budgets to fund the new bodies, cash was being cut even though the government was asking local groups to take on a range of new responsibilities, such as promoting the integration of care and health services and improving choice for patients, without extra money.

Alexander said: “It’s pathetic. The consultation had a figure of £20,000, which was confusing and looked like a cut. Then that was withdrawn. Our figures show that networks are having their budgets cut this year by 24% on average.”

He said there was no start-up funding for local HealthWatch “pathfinder” groups and no ringfenced money in local authority budgets to run the new bodies.

The money for HealthWatch comes out of local council budgets, which are being cut by 30% over the next four years. “Our own research asked whether these new policies were evolution or abolition. It looks like abolition to us,” he said.

Sally Brearley, senior research fellow in patient and public involvement at King’s College London, who sat on the prime minister’s Future Forum which re-examined the health reforms, said she “shared the concerns”.

“There’s a lot of extra work to develop these new HealthWatch bodies and they are supposed to be monitoring the NHS as services are being cut and finances are under strain. It’s a real issue.”

A Department of Health spokesperson said the criticism was misleading.

“The government has not cut funding, and has no plans to do so – in fact, we retained the current level of funding at £27m, rising in line with inflation, for the spending review period.”

From: http://www.guardian.co.uk/andrew-lansley-condemned-healthwatch

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.The integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

From: http://www.telegraph.co.uk/NHS-should-consider-abandoning-7bn-IT-project.html

Drinks industry lobbyists now make up almost half the members of a key body tasked with advising ministers on alcohol policy, research papers show.
Seven out of 16 members of the Government and Partners Alcohol Working Group are from industry, up from just a couple last autumn.

Critics believe it is evidence that the Coalition is pandering to the interests of the drinks industry, potentially at the expense of the nation’s health.

Some nine million people in Britain suffer from the harms of alcohol in some, either directly or indirectly, while the cost to the NHS stands at £2.7 billion a year.

Don Shenker, chief executive of the charity Alcohol Concern, believed companies were being allowed a bigger say in “setting the agenda” under the Coalition.

Speaking of the changes to the working group “I can only imagine it’s because this government believes that the drinks industry has a big role to play in shaping policy, in setting the agenda.

“And so they have extended the invitations to a larger set of people from the drinks industry.”

However, Anne Milton, the Public Health Minister, claimed ignorance of the body.

She said: “I think we have a communications problem in Whitehall because you know something that I have never heard of before.”

In opposition David Cameron talked tough on alcohol abuse, and the Conservatives’ manifesto said the party would ban off-licences and supermarkets from selling alcohol below cost price.

In January the Coalition announced that retailers would be banned from selling drinks for less than the value of duty and VAT.

But they will not have to take into account the cost of producing the drinks, meaning they will still be able to sell drinks at a net loss.

The Coalition has pursued an approach of working with industry, arguing it will be more effective than legislation.

However, in March eight organisations pulled out of the Coalition’s Public Health Responsibility Deal – including Alcohol Concern, the Institute of Alcohol Studies and the British Liver Trust.

They wrote to Andrew Lansley, the Health Secretary, saying the deal on alcohol – which includes voluntary agreements with industry – would not help reduce illness or deaths.

At the time Mr Lansley said imposing laws was often “costly” and they could “take years” to implement.

A spokesman for the Department of Health yesterday re-iterated that argument.

She did not deny that changes to the working group had been made.

The spokesman said: “We are committed to challenging the assumption that the only way to change people’s behaviour is through adding to rules and regulations.

From: http://www.telegraph.co.uk/Alcohol-advisory-body-stacked-with-drinks-industry-lobbyists

The government is under pressure to consider tax rises and further spending cuts to find the money to pay for the overhaul of social health care.
An independent review has recommended individual costs be capped at £35,000 – a move which would cost £1.7bn a year.

Ministers have said they will consider the proposals, but the Treasury is known to have reservations.

However, both the Dilnot Commission and campaigners are preparing to keep the pressure on in the coming months.

Commission chairman Andrew Dilnot is urging ministers to act quickly and consider ways extra funds could be found.

After launching his report on Monday, he said he wanted to see the government come forward with a white paper by Easter, paving the way for the introduction of the new system by the end of this parliament.
‘Build momentum’

Meetings are now being planned with officials about how his proposals would work in practice.

He is said to be confident that he will be able to win the argument and wants to use the next few months to “build momentum” around his plans.

The Dilnot Commission’s proposals would require an extra £1.7bn a year – a figure which would rise along with the ageing population.

This could be found by making cuts elsewhere. The NHS has already been pinpointed as it has a budget of over £100bn and many of its services overlap with social care.

Alternatively, £3bn a year could be raised through getting those who work past the normal retirement age to pay national insurance contributions or through an across the board rise of 0.25% in contributions

Increasing the basic rate of income tax by 0.25%, VAT by 0.5% or reducing pension tax relief would bring in £2bn a year.

In a warning to ministers, he said if they did not act before Easter the commission’s feelings would move “quickly to disappointment”.

His case is being strengthened by having widespread support from charities – some of whom are involved in delivering social care services.

More than 20 charities, including Carers UK and Mencap, immediately put their names to a joint statement calling for action.

It said: “It is now vital that government sets out a clear timetable for change and does so quickly.”

Many of them will also be seeking talks with government in the coming months. A number of options are being put forward for finding the money.

These include taking money from other departments as the £1.7bn represents just 0.25% of total government spending.

It will also be argued that improving social care will help save the NHS money as fewer people will need expensive hospital treatment if they get better access to social care.

However, raising more through taxes or the benefits system will also be put forward.

An analysis from Age UK setting out how this could be done has already been handed over to the Treasury.

It includes suggestions such as making those working past the normal retirement age pay national insurance contributions. This would raise £3bn a year.

Alternatively a 0.25% rise in contributions across the board would make a similar amount.

Meanwhile, £2bn could be found by either increasing the basic rate of income tax by 0.25%, VAT by 0.5% or reducing pension tax relief.

For any of these to happen, cross-party support would almost certainly be needed.

The Labour party has already indicated it would be willing to enter talks. But doubts still remain about the appetite for change.

In his official response to the Dilnot Commission, Health Secretary Andrew Lansley said the proposals would be “carefully considered”.

But he acknowledged they would involve “significant cost” and need to be balanced against other funding priorities.

A spokeswoman for the Treasury refused to be drawn on any of the suggestions.

But she said officials would welcome “constructive engagement from all stakeholders”.

Michelle Mitchell, of Age UK, said: “The government now needs to act on Andrew Dilnot’s proposals. Delay would be indefensible.”

And Richard Humphries, of the King’s Fund health think-tank, added: “A solution must be found.

“What we are talking about is a relatively small proportion of government spending.”

From: http://www.bbc.co.uk/news/health-14017252

David Cameron has agreed to make changes to the plans for the NHS in England and insisted the government had not made “a humiliating U-turn”.
Ministers have accepted all the recommendations suggested by a panel of experts, including more controls on competition and a slower pace of change.

Doctors’ groups have broadly welcomed the revisions.

The NHS bill will now go back to the committee stage in the House of Commons to be scrutinised again by MPs before going through its House of Lords stages.

The prime minister’s official spokesman said he expected that to happen before the summer recess begins in July, and the bill to be on the statute book by the end of the current Parliamentary session.

That gives ministers until May 2012 to make it law.

On Monday – following a 10-week “listening exercise” – a panel of experts called the NHS Future Forum gave its recommendations on the changes needed to the bill.

They include:

• Reinstating the legal responsibility of the health secretary for the overall performance of the NHS
• Scrapping the primary role of the regulator, Monitor, to promote competition – and focusing on improving patient choice instead
• Relaxing the 2013 deadline for new GP commissioning arrangements to be introduced – a National Commissioning Board, based in Leeds, will control budgets until GP groups are “able and willing” to take over
• Strengthening the power of health and well-being boards, which are being set up by councils, to oversee commissioning and giving patients a greater role on them
• Retaining a lead role for GPs in decision-making, but boosting the role of other professionals such as hospital doctors and nurses alongside them

After criticism from medics and complaints from rebellious MPs, the Coalition will be hoping the dust will now settle over its NHS reforms.

If politics is the art of persuasion, then the test for Messrs Cameron, Clegg and Lansley is whether or not they have convinced people that the listening process has been, as the prime minister claimed, a sign of strength.

The government and many health professionals believe changes to the NHS are necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes such as obesity.

Mr Cameron said those who described the reworking of the plans as “a humiliating U-turn”, or the listening exercise as “a big PR stunt”, were both wrong.

“The fundamentals of our plans – more control to patients, more power to doctors and nurses, less bureaucracy in the NHS – they are as strong today as they’ve ever been,” the PM said.

The health secretary has faced personal criticism for his inability to garner widespread support for the original bill, but the prime minister said he accepted full responsibility for what had happened.

“I am every bit as responsible as Andrew Lansley for the fact that we actually decided we could improve on what we already put forward,” Mr Cameron said.

The British Medical Association said it was pleased the government had accepted the Future Forum’s recommendations and addressed many of doctors’ concerns.

But it said more detail was needed on how commissioning of care would work in future and there must be “robust safeguards” to prevent competition of any kind destabilising the health service.

From: http://www.bbc.co.uk/news/uk-politics-13757380