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Editor’s blog Tuesday 6 July 2010: EXCLUSIVE – Coalition government’s NHS White Paper due end of July, with five consultations

Health Policy Insight understands that the NHS White Paper will be launched at the end of July. It will be accompanied by five consultation documents, on various aspects of policy.

UPDATE: As you may well be aware, events have moved on rather fast since this was written. See here for own-word-consumption.

The standard timescale for government consultation is twelve weeks, suggesting that a revised White Paper would then be finalised in late October, enabling the legislative process in Parliament to begin in November.

The five areas for consultation are understood to be:
- service reconfiguration
- GP commissioning
- patient choice and local democracy
- the independent commissioning board
- regulation and performance management

This was put to the Department of Health's press office, who said that "there is no date and no further information".

What this all means
It would be cynical to characterise the White Paper as more of a Blank Paper. Nevertheless, it is concerning that Health Secretary Andrew Lansley MP CBE released Autonomy And Accountability in 2007, and yet has come to the table so detail-lite on the obvious issue of financial governance arrangements.

Confidence in the draft White Paper does not appear to be high. This is concerning, given the very public noises from Sir Gus O’Donnell and colleagues prior to the election about giving the Conservative opposition (who were then still widely fancied to win an overall majority alone) access to civil servants to prepare for their transition into power. Such access as they had does not appear to have been well used.

The fog of uncertainty is unhelpful and destabilising for people’s ability to plan their next career moves. More than ever, a formal clarification that (pilots aside) no changes will happen before a certain date seems essential.

The proposals outlined so far leave PCTs as little more than locally-elected community health councils. Such effective commissioners as there are in PCTland (and there are a few) will be out the door like rabbits.

The proposal for these five consultations can be viewed in one of two ways: either as admirable recognition that there was not an unambiguous democratic mandate for the Conservatives’ changes (which people had three years to assimilate); or as straightforward uncertainty about what to do.

In that latter view, the NHS White Paper is effectively a Green Paper.

UPDATE: As you may well be aware, events have moved on rather fast since this was written. See here for own-word-consumption.