Scrap the health bill, GP urges David Cameron - The Guardian

A GP who was an adviser to the health secretary has urged the prime minister to scrap the health and social care bill.

Dr Sam Everington is chair of the clinical commissioning group (CCG) of GPs in Tower Hamlets in east London. Under the NHS shakeup, CCGs will gain control of local health budgets from April next year, taking over from primary care trusts. His CCG is the first to demand that the bill is dropped, although senior doctors believe that others will follow suit.

Until now Everington supported the plan to hand GP consortiums power and money, the main object of the bill. The Bromley-by-Bow surgery in Tower Hamlets where he works, widely admired as an example of innovative good practice to improve patients' care, hosted Andrew Lansley's first speech as health secretary after the 2010 election. In a letter to David Cameron, Everington warns that "your rolling restructuring of the NHS compromises our ability to focus on what really counts" and that improvements to NHS primary care could be made "without the bureaucracy generated by the bill."

While GPs in Tower Hamlets support clinical involvement in commissioning care, "an act of parliament is not needed to make this happen", he said. Cameron should also not mistake GPs' involvement in CCGs, which now cover 95% of England, as backing for them, added Everington. "Your government has interpreted our commitment to our patients as support for the bill. It is not", he said.

Dr Clare Gerada, chair of the Royal College of General Practitioners, said by insisting the bill was unnecessary to improve primary care, Everington had distilled a belief shared by many GPs. Dr Peter Carter, general secretary of the Royal College of Nursing, said the CCG's call was "significant, especially as they [CCGs] were supposed to be at the heart of the government's NHS reforms."

Andy Burnham, the shadow health secretary, said: "Even doctors who were in the vanguard of Mr Lansley's changes are now deserting him and adding their voice to the Drop the Bill campaign. It is humiliating for the Health Secretary to receive this letter of resignation from the practice where he made his first speech as health secretary."

But the Department of Health brushed off the letter. "GPs in Tower Hamlets, like all GPs, will be able to take these powers to benefit their local patients, and only with the bill can we make clinical commissioning a reality for patients across the country. That is why the NHS Alliance and National Association of Primary Care — who represent over 11,000 primary care clinicians — support our proposals", said a spokesman.

"Without the bill, doctors and nurses will always run the risk of having their decisions second-guessed by the managers running primary care trusts. The bill cuts out this needless bureaucracy and hands control for care over to those who know their patients best — the doctors and nurses throughout the NHS", he added.

Lansley faced tough questioning in the Commons over a raft of new amendments to the bill being sought by Nick Clegg and Shirley Williams for the Liberal Democrats. The health secretary said that the changes they are seeking would be "significant".

He was responding to an emergency question from Burnham after the coalition government's apparent confusion over the changes announced on Monday by the deputy prime minister.

In an effort to head off a Lib Dem backlash against the bill at the party's spring conference in March, Clegg wrote to his MPs and peers promising important changes to "rule out beyond doubt any threat of a US-style market in the NHS". However the promise of five amendments through the House of Lords was undermined after Downing Street said that the changes were "not significant". Ministers have also said there would be no further changes to the bill.

Burnham challenged Lansley to tell MPs whether the latest changes were "substantial or cosmetic", and whether they had been agreed by the prime minister and health secretary in advance.

"The government appears in complete disarray, or maybe it was... coalition choreography to save face for the deputy prime minister," said Burnham. "The NHS matters too much to leave it to be carved up in cosy coalition deals."

Lansley avoided at least three times answering questions about whether he had been consulted about Clegg's letter. "The point of the letter was to reflect the discussions we have been having," he said in reply to Labour MP Gisela Stuart.

Rushanara Ali, Labour MP for Bethnal Green and Bow qwhose constituency includes Tower Hamlets, challenged Lansley on Everington's letter. "When the very structures he's establishing to advise him are telling him they don't want [anything] to do with this nightmare he's creating, isn't it time to look again and drop the bill?" said Ali.

Lansley replied: "They will use the powers in this bill and they will use them effectively."

Later Burnham also criticised the decision of the backbench business committee of MPs not to debate the e-petition signed by 162,000 people asking for the health bill to be dropped.

E-petitions hosted by the government website are eligible for debate when they are signed by more than 100,000 people.