With GP commissioning groups now holding most of the NHS purse strings, the coalition's northern MPs will be hoping the unpopular gamble pays off, says Ed Jacobs
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guardian.co.uk, Monday 1 April 2013 17.01 BST
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Jeremy Hunt inherited the NHS reforms from his predecessor as health secretary, Andrew Lansley, but now has the difficult job of being their cheerleader. Photograph: Jeff Overs/BBC/PA
They are "visible from space", according to the blunt assessment of the embattled NHS chief executive Sir David Nicholson, and on Monday the massive changes to the way the NHS is run came into force.
The coalition agreement of 2010 pledged that ministers would "stop the top-down reorganisations of the NHS that have got in the way of patient care". Yet in Nicholson's own words, the changes being made are not just a reorganisation, but a massive reorganisation at that.
Costing by some estimates in the region of £3bn, the changes put GPs in charge of commissioning all healthcare with a new national NHS commissioning board overseeing the new arrangements and having responsibility for budgeting for specialist services, such as complex surgery, rare cancers, and other areas, such as dentistry.
Ministers believe this will increase healthy competition, while critics fear that multinational healthcare businesses will end up cherry picking profitable procedures, leaving the NHS lumbered with the rest.
Across the north of England, figures from Ipsos Mori show that behind the perennial issues of the economy, immigration and unemployment, the NHS is the fourth most important issue for voters in the region. The figures however do not tell the full picture and public opinion seems not to be on the government's side.
Looking at polling produced by ComRes for ITV News, when taking an average of findings from across the north's three regions, the findings show:
• More than 47% feel that the quality of care in the NHS since the coalition came to power has got worse. This compared with just 6% who feel that it has got better.
• While just under 50% of respondents believe that the NHS provides a high standard of care to patients in the wake of the Mid Staffs scandal, over 77% believe that the NHS is "more focused on meeting government targets than on ensuring high standards of patient care".
• The North is far from convinced that the government's reforms will improve the service, with over 43% disagreeing that they will improve standards compared with 16% who believe standards will improve as a result.
• Finally, joining George Osborne in the crowded box marked 'unpopular ministers' is the health secretary, Jeremy Hunt, who was brought in by David Cameron to improve the Tories' image on the health service following Andrew Lansley's difficulty tenure. Less than 10% of respondents think he is doing a good job, the rest either being indifferent or arguing he is doing a bad job.
As GPs, hospitals and patients get to grips with reforms that are so controversial that in September it led David Cameron to shuffle all but one minister out of the Department of Health, ministers may now be hoping that the fears that many have expressed about the changes will not come to fruition. That is about all they can now do.
Ed Jacobs is a political consultant at the Leeds-based Public Affairs Company and devolution correspondent for the centre-left political and policy blog Left Foot Forward
