However, this does not appear to be a u-turn, it is merely a welcome watering down, nothing more.
The Telegraph reports that the Bill will be changed with:
- New clauses limiting the ability of private firms to "cherry-pick" the most lucrative work, by ensuring that payments match the complexity of treatment;
- Attempts to redefine the role of the system's regulator, so that value for money replaces promotion of competition as its prime duty;
- Improved public accountability for the GP consortia, which are intended to ultimately take control of around £60 billion of public money each year.
- Mr Cameron's intervention means the timetable for the reforms will be relaxed, with 2013 no longer treated as a deadline, and no doctors forced into consortia against their wishes. However, in parts of the country where GPs do not agree to form such groups, powers could instead be given to GP consortia from other parts of the country.
The last point in the list above is worrying. If consortia from other parts of the country can take over commissioning then there will be a crisis of independence far worse than a postcode lottery: people will see a private organisation from another area force rationing on them. In fact, this may well be a PR disaster for Cameron since people in the area having rationing forced on them may point to the difference between what is happening to them and the policies of the area of the overlord consortia.
Finally, what happens to Lansley, what happens to tweedledum and tweedledee (Alexander and Letwin) who signed off the original Bill at the end of last year? If Cameron forces any significant changes then he is saying that all three were wrong and crucially, it shows that he cannot trust Letwin to act as a troubleshooter. The LibDems will also see Alexander as too closely wedded to Letwin since he did not recommend changes to the Bill before publication.