New Health Minister Anna Soubry has said the Government failed to “encourage the support of health professionals” for the NHS reforms.

Asked during a private Q&A about how the Government had communicated its ideas to health professionals, Soubry declared: “We screwed up.”

The listening exercise had taken the “rare step” of amending legislation in response to public concerns, she said.

Soubry, a Conservative MP, was Parliamentary Private Secretary to Health Minister Simon Burns at the time of the original Health and Social Care Bill.

Following widespread reporting of her “We screwed up” admission, Soubry clarified that she had always supported the Bill.

However, she said, “We could have done more when the plans were set out initially to explain the benefits for patients, and encourage the support of health professionals.

“That is exactly why we took the rare step last year of pausing the legislation and holding a listening exercise. We ensured we took on people’s concerns and improved our plans.”

This account of the ‘listening exercise’ contrasts with former Health Secretary Andrew Lansley’s statement in April that the exercise had not changed the Health Bill.

Its purpose was to explain the Bill and “give further reassurance” to clinicians who had “not read it” or had “not really understood it”, he said.

Shadow Health Minister Jamie Reed rejected the new DH narrative, saying the Government “is completely out of touch if they think the only problem with their NHS plans is one of presentation.”

The new Care Services Minister, Norman Lamb, was strongly critical of the Health and Social Care Bill in its original form.

His argument that the new NHS system was being “rushed into” without regard for the needs of GPs helped to stimulate amendments to the reform plans following the ‘listening exercise’.

Lamb is considered a leading Liberal Democrat spokesman on health, but political disagreements with Andrew Lansley led to his being denied a ministerial post until now.

In April 2011, Lamb threatened to resign from his position as chief political advisor to Nick Clegg if the Health and Social Care Bill was not amended.

His main concern was that the reform was not “evolutionary”: the changes were being “rushed into” without keeping GPs on board. He argued for a phased process that allowed GPs to ‘opt into’ the new system.

However, following the ‘listening exercise’, Lamb supported the amended Health Bill and said the Lib Dems had acted as a “safety valve” to allow its improvement.

Lamb’s appointment as Care Services Minister, replacing Paul Burstow, brings into the DH a major source of health expertise – potentially both a support and a counterpart to the new Health Secretary.

Other health ministers have moved on this week: Nursing and Public Health Minister Anne Milton is replaced by former journalist Anna Soubry; while Health Minister Simon Burns, promoted to Transport Minister, is replaced by former Health Select Committee member Dr Daniel Poulter.

Earl Howe, who steered the Health Bill through the House of Lords, keeps his ministerial role.

Seven NHS trusts on the brink of bankruptcy will be visited by Government ‘hit squads’ in an attempt to reverse ailing finances.

Government lawyers and auditors are to be sent to trusts hindered by private finance initiative (PFI) contracts in an attempt to save up to £1.5 billion.

Health Minister Simon Burns (pictured) said the deals were “absolutely disgraceful” and the contracts show a “cavalier disregard” for taxpayers’ money.

The seven trusts set to be visited by the ‘hit squads’ are: Barking, Havering and Redbridge; Dartford and Gravesham; Maidstone and Tunbridge Wells; North Cumbria; Peterborough and Stamford Hospitals; and St Helens and Knowsley NHS Trust.

It’s also believed that the ‘hit squad’ will also visit South London Healthcare Trust – the first NHS trust to be placed into administration – as part of the cost saving measures.

Mr Burns said that officials had analysed various PFI contracts and identified billions of pounds’ worth of savings.

It’s believed that throughout the NHS there are PFI deals worth more than £79bn. While the Government says it will not walk away from these contracts and leave the NHS with years of legal disputes, it is now focusing on means of reducing repayments.

“Seven hospitals got it horribly wrong,” Mr Burns said. “It is an absolute disgrace.

“The problem is some of these contracts are 2,000 pages long and realistically I suspect very few people have looked through them and been able to identify all the implications and potentials to make sure they are getting a good deal.”

Sir Michael Rawlins wants campaigners to take legal action against trusts that deny patients access to NICE-recommended drugs. Maxine Vaccine asks whether this is a powerful strike against bureaucracy or a pointless fit of sulking.

It’s not easy being NICE. When you decide a drug is not cost-effective, the manufacturer contacts a bunch of patient groups on Facebook and passes on soundbites to the press that make you out to be the most heartless despot since King Herod. When you decide a drug is cost-effective, the NHS quietly ignores you.

The Government says it will force trusts to make NICE-approved treatments available to patients – but at the same time, the recession comes back for whatever it forgot to wreck the first time, and the NHS is told it has to make deep spending cuts for the foreseeable future. Andrew Lansley first praises the NHS for hacking nearly £6 billion from its budget, then says rationing of NHS treatments is “unacceptable”. Simon Burns tells Radio Five Live that Monitor will sack CCG leaders who ration services, then the DH shamefacedly explains that he meant to say the Commissioning Board would do that.

And just to make matters worse, if you’re Sir Michael Rawlins, people confuse you with Sir Andrew Dillon and vice versa. Is it your fault that you both look exactly like 1970s newsreaders? Having good taste in neckwear wasn’t part of your job description. And you both have something of the knight about you. It’s time you stood up for yourself.

At least, that’s my rationalisation of why Rawlins went on the HSJ website and revealed that he encouraged the RNIB to take legal action against the NHS. I could be wrong, however. He may have had a touch of the sun, or a bout of lansley that his GP wasn’t allowed to prescribe for.

Whatever the reasons, his blog was in the awesome NICE tradition of standing on the moral high ground and waxing ironic over those below. He recommended that patient groups should use legal measures to “blow the whistle” on trusts that use “delaying tactics” to save money – thereby forcing them to put in place “appropriate financial arrangements” for the drugs in question to be provided. Then came his parting shot: “That would be a much better use of the time of formulary committees than trying to pretend they have the knowledge and skills of a NICE appraisal committee.”

Strangely enough, that didn’t go down too well with the NHS. David Stout, Chief Executive of the NHS Confederation, responded with an air of wounded dignity: “We must remember the reality is that every NHS organisation has a finite amount of money available. Every new treatment covered and funded under a NICE technology appraisal means fewer resources for other treatments.

“The issue raised by Sir Michael Rawlins leads us on to the wider debate that we need to have about the fact that the NHS is facing an unprecedented financial challenge,” he continued. “We need to be open and honest with the public about what the consequences of this financial challenge are, and the fact that trade-offs will be required if we are to improve standards of care while keeping the NHS affordable.”

That is rather good – and it cuts through the DH’s excuses like a scalpel through the contents of an inflamed colorectal tract. We need a public debate about NHS rationing – its economics, its democratic basis, its medical and social impact – not confused denials that such activity was ever dreamt of. If it was Rawlins’ intention to force that debate into the public space, he did well.

Bring it on.

Maxine’s views are not necessarily those of Pharmaceutical Field.

Labour plans to scrap the Government’s controversial NHS reforms if they win the next general election, Shadow Health Secretary Andy Burnham (pictured) has said.

Speaking in Parliament during a debate opposing the reforms, Mr Burnham insisted the changes open the door to privatisation within the NHS and undermine the health service in general.

He said that Labour will “repeal the bill” if elected claiming it to be a “defective, sub-optimal piece of legislation” that has left the NHS with a “complicated mess”.

The Shadow Health Secretary added that it would be “irresponsible” to leave the Health Act in place if Labour were elected and added that the “gap between ministers’ complacent statements and people’s real experience of the NHS gets wider every week”.

“They are in denial about the effects of their reorganisation in the real world, it is dangerous complacency and it can’t be allowed to continue.”

Health Minister Simon Burns countered Mr Burnham’s claims by reminding the Leigh MP that Labour leader Ed Miliband had previously said he would keep clinical commissioning in place if elected as prime minister.

But the former Health Secretary insisted “it’s not about the organisations, it’s about the services they provide”.

“The existing organisations can be asked to work differently, as I would ask them to work differently,” he said.

“I don’t want those NHS organisations in outright competition, hospital versus hospital. I want them working collaboratively.”

The NHS has underspent its budget for 2011–12 by £1.7bn, but only £300m (18%) of that has been kept for next year’s budget.

The requirement to return £1.4bn to the Treasury breaks Sir David Nicholson’s promise in October 2010 that “every penny” saved by the NHS would be reinvested in patient care.

It also means that while the NHS budget increased slightly relative to 2010–11, there was a small drop in real-terms NHS spending.

The NHS could only use the ‘budget exchange’ mechanism, which allows a department to retain unspent budget, for a fifth of its cost savings.

Its underspend was the largest by any Whitehall department, though the NHS was the only department whose budget was not reduced.

The NHS savings target of £20bn by 2014 is not meant to include budget cuts: it represents the savings needed to keep budget increases very slight despite inflation and demographic changes.

In 2010–11 the NHS underspent £900m, of which only £400m was retained by the department.

The loss of budget savings is a consequence of the Government’s 2010 spending review, which abolished the ‘end of year flexibility’ arrangement that allowed a department to roll over unspent funding.

Health Minister Simon Burns commented that NHS savings in 2011–12 had been made by cutting back on “bureaucracy and IT”, while spending on “frontline services” had increased by £3.4bn.

The rationing of NHS services has become a focus of political debate, though all politicians involved have condemned it.

A Shadow Health Minister has called for “an immediate review” of rationing and action on clinically unjustified decisions.

Health Minister Simon Burns has said that CCG leaders may be sacked if they fail to correct cost-driven restrictions on care.

In June, a study published by GP magazine revealed that 91% of PCTs impose limits on referrals for ‘non-urgent’ procedures such as cataract surgery and hip and knee replacements.

Clinicians have argued that these procedures, when delayed, become both more urgent and more costly, while patient wellbeing suffers.

Following a Parliamentary debate on this issue, Health Secretary Andrew Lansley insisted that “blanket plans on treatments” are “unacceptable”.

He argued that the new CCG structure would give GPs more power to resist rationing, because they would no longer be dictated to by PCTs.

Simon Burns told radio listeners that PCT leaders could be dismissed by the DH if they failed to restore clinically necessary services. In future, he added, Monitor could exert the same sanction on CCG leaders.

The DH subsequently clarified that the NHS Commissioning Board, not Monitor, would have that power.

Shadow Health Minister Lord Hunt of King’s Heath (pictured) called online for “an immediate review of rationing in the NHS”, with action to reverse “treatment restrictions” that caused suffering or restricted independence.

The decision whether to make a treatment available should be made at a national level, he argued, rather than locally and “in a random fashion”.

As Chair of Heart of England NHS Foundation Trust, Lord Hunt has stated that ‘efficiency savings’ should not affect the quality of NHS services.

Representatives of the DH and the NHS Confederation have disagreed over the importance of NICE guidance.

A trust survey by GP magazine that showed ‘non-urgent’ operations are being rationed by most trusts triggered a variety of official responses.

The survey found that 90% of trusts were rationing tonsillectomies, two-thirds were rationing cataract surgery, and more than half were rationing weight loss surgery and hip and knee operations.

These findings are similar to ones published a year before – but in the meantime, public concern over the impact of NHS spending cuts has deepened.

The BMA’s Dr Richard Vautrey said: “We’re supposed to have a national health service, so there should be national consistency in service availability.”

Health Minister Simon Burns called rationing “unacceptable” and promised: “If local health bodies stop patients from having treatments on the basis of cost alone, we will take action against them.”

His comments echo recent Government pledges to ensure that NICE guidelines are more closely followed.

However, David Stout (pictured), Deputy Chief Executive of the NHS Confederation, justified rationing by trusts: “The NHS faces considerable financial pressures and scarce resources have to be used as effectively as possible.”

NICE guidelines were “just advice”, he argued, and trusts should not try to follow them closely – though national consistency would have “some advantages”.

The Department of Health has unveiled a new 45-point plan for the NHS to follow to identify and treat people with respiratory problems.

A Companion Document to the Outcomes Strategy for COPD and Asthma includes advice on diagnosis and treating people which may help the NHS prevent an estimated 7,800 deaths annually.

Chronic Obstructive Pulmonary Disease (COPD) kills around 23,000 people per year and is the UK’s biggest killer disease. The UK also has the highest prevalence of asthma around the globe with between 1,000 and 1,200 deaths per year.

Health Minister Simon Burns called COPD one of the UK’s “hidden killers” and said with “proper diagnosis and treatment we can make a big difference”.

A key part of the strategy is reducing the variation in COPD diagnosis and care. Currently the north of England had better diagnosis rates than the south – yet has higher death rates.

The NHS currently spends around £1 billion annually on treating COPD. Around 3.2 million adults have the disease – with an estimated 2.1 million going undiagnosed.

The strategy outlines how the NHS should provide the “right interventions” through better provision of a form of artificially aided breathing in hospitals and by providing spirometry lung tests during diagnosis.

It is hoped that following the top five action points in the strategy could lead to savings of around £500 million over the next ten years.

Dame Helena Shovelton, Chief Executive of the British Lung Foundation, backed the plans. “This new action plan shows that the government is serious about fulfilling the promises made in last year’s COPD and asthma strategy, which we campaigned so long to bring about,” she commented.

“By looking to improve diagnosis and treatment, this new action plan will therefore not just save lives, but could dramatically improve the quality of life for hundreds of thousands of COPD sufferers nationwide.”

Another NHS hospital trust is in talks with potential private sector and NHS partners to help ensure its survival.

The George Eliot Hospital NHS Trust in Nuneaton is looking for a partner to enable it to achieve Foundation Trust status by the April 2014 deadline.

Four months after signing a 10-year contract to run the Hinchingbrooke NHS Trust in Huntingdonshire, Circle is among the bidders for the George Eliot contract.

At the time, Health Minister Simon Burns commented: “This is not a blueprint or model to be used by other hospitals.”

An estimated 20 NHS hospital trusts will need a partner organisation for reasons of size or financial difficulty.

Three private healthcare providers have bid to run the George Eliot Hospital NHS Trust: Care UK, Circle and Serco Group.

Three NHS Foundation Trusts have also bid for the contract: those of Burton Hospitals, Dudley Group and South Warwickshire.

Kevin McGee, Chief Executive of the George Eliot trust, said: “It is important to be clear that we are not at the stage of selecting an organisation to partner with; we are investigating what future shape our hospital should take and how best to achieve that.”

“We understand the George Eliot Hospital NHS Trust has recently begun to explore a range of options, which might include partnerships with the independent sector,” commented a Department of Health spokesperson.

“However, it is very early days and exactly what model this might be is yet to be determined locally.”