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The GuardianThe health secretary has unveiled a radical pro-market agenda for the NHS that would permit hospitals to leave public ownership to become "not for profit" companies, hand more consumer powers to patients and allow failing medical centres to go bust.
Andrew Lansley's white paper, which sparked anger from unions and some doctors, could, in the words of one analyst, herald the "denationalisation of healthcare services in England".
The plans could represent the biggest shakeup of the NHS in a generation, with a whole tier of the NHS decapitated: 10 strategic health authorities would be abolished by 2012 and the 150 primary care trusts scrapped by 2013; up to 30,000 managers face being cut or redeployed.
Lansley warned that NHS job losses were "inevitable" but said it was vital to switch cash from bureaucracy into frontline services. "The sick must not pay for the debt crisis left by the previous administration. But the NHS is a priority for reform too. Investment has not been matched by reform. So we will reform the NHS to use those resources more effectively for the benefit of patients."
At the heart of the blueprint are family doctors, who will take over the purchase of care and be overseen by an independent commissioning board and a new economic regulator. England's 35,000 GPs will be handed £80bn of taxpayers' money and be forced to form consortiums by 2013 – there will be no opportunity to opt out of the new system. These 500 consortiums will commission treatment from hospitals on behalf of patients. At present, the NHS works via primary care trusts and the Department of Health determines each trust's spending priorities, which involves managing GPs' surgeries.
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http://www.guardian.co.uk/society/2010/jul/12/nhs-health-reform-andrew-lansley