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Without fanfare, the Bill receives assent

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Competition may increase in the NHS Competition may increase in the NHS

What would you say dominated last week's national news? The publication of the UK Riot Report? Or the promise of hosepipe bans, petrol shortages and price hikes in stamps and hot pies?

For once, it wasn't the NHS, despite the health service being described - only half-jokingly - as our 'national religion'; despite the leaked publication of the Transitional Risk Assessment; and despite the fact that, on 27 March, the controversial Health and Social Care Bill quietly received Royal Assent to become the Health and Social Care Act (2012).

The risk assessment, leaked anonymously last Monday evening to GP and broadcaster Dr Phil Hammond and NHS commentator Roy Lilley, contained a lot of red, symbolising high risk. For example, it warned of consequences where 'implementation begins without adequate planning'. It said that 'by dismantling the current management structures and controls, more failures including financial (e.g GP consortia going bust or having to cut services)' could occur.

It pointed out that 'as the bill proceeds through parliamentary stages, amendments are made which have unforeseen consequences for the system, with possible impact on costs or performance of the system'.

These risks have been pointed out by health professionals, but it is disturbing to see them spelled out in black and white (and red) by experienced DH professionals, when it is too late to address them.

By Easter, the Bill will be law and commissioning groups could become statutory organisations from April 2013. Health professionals continue to fear the impact of increasing competition in the NHS.

While the public grieves for cheap pies and plentiful petrol, their beloved NHS may face much greater change, the consequences of which will be felt later down the line.


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