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Health reform: Controversial reforms will become law

The Government's hugely controversial bill to transform the way healthcare is administered in the UK will become law, after a vote yesterday evening in the House of Commons.

In the end, despite all the controversy and argument, the final vote passed quietly. After 14 months of stop-start negotiations, the new law will finally be implemented, with plans to have many of the provisions in place within a year.

The major focus of the change in legislation will be service commissioned not by Primary Care Trusts, but by GP-led consortia. The bill will inject more competition into the NHS, and creates new bodies to regulate the way money is spent, assess local health needs and represent patients better.

Mike Farrar is chief executive of the NHS Confederation.

"A lot of staff on the ground lack confidence in the bill, or say they don't like it, at a time when we need massive energy and commitment from staff. It makes it harder," he said.

The NHS is used to change, but many see this as the biggest change in its 64-year history, and this is emphasised even more as the service looks to trim some £20bn from its budget between now and 2015. With this in mind, observers see funding pressures coming to the forefront of the debate on health.

Professor Chris Ham is chief executive of the King's Fund.

"The reforms will not have a major impact in this Parliament. But you will start to see trusts fail to meet four-hour accident and emergency waiting targets, you'll see a high level of bed occupancy and planned surgery being postponed," he envisages.

There are difficult times ahead. As budgets tighten, many predict that the GPs now responsible for commissioning will look to the private sector for greater value. It is thought that in some areas, GPs will exercise newfound powers, by diverting resources away from hospitals they do not like or rate. This will undoubtedly affect some hospital budgets, and closures are seen as almost inevitable.

It is still unclear who the winners and losers will be when the bill becomes law. Andrew Lansley, the Health Secretary, must consider himself a victor for getting his controversial vision through Parliament.

However, it has not been without considerable amendments from Labour, who can claim to have steered the reforms in their own direction somewhat. Time will tell whether this is a good day for the NHS or not.

Related links:

Read more on the story (The Guardian)

How laws are made in Parliament (FindLaw)