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Government backs down over health and social care billBy: Patrick Butler The government has made key concessions over two of the most controversial parts of its health and social care bill in order to ease its passage through parliament before the general election. Ministers last night caved in to pressure from local authorities and withdrew plans which would give them the power to force failing social services and community services providers into care trusts. In the face of pressure from Conservative peers, they also scrapped a proposal to control the use of anonymised patient data by pharmaceutical companies. But they refused to give way on plans to give the health secretary powers to sanction the use of confidential patient information without patient consent where it is in the "public interest," such as for use by cancer research bodies. The concessions follow a government defeat in the Lords last month over its plans to abolish community health councils (CHCs) - although ministers said they will reverse this defeat in the Commons. Health minister Lord Hunt told the House of Lords last night that the government had "thought again" about making care trusts compulsory in the light of peers' concerns. "We have concluded that the best way to respond to those concerns is to withdraw the proposals for compulsory care trusts," he said. Local authorities have been doggedly opposed to care trusts because of fears that they will effectively fold social services into an NHS-dominated management structure. Although they have failed to prevent the creation of care trusts, the concession over plans to impose them will be welcomed by local government as a significant compromise by ministers. The change means that local authorities and NHS bodies will not be dragooned into care trusts where local services have failed and cannot be improved within existing arrangements. But Lord Hunt added that the government would not shirk from taking corrective action against failing services. "Although we agree that compulsory care trusts may not be the right approach, the amendments that I propose leave intact the powers to require the use of the health act partnership in response to service failure. "The government had sought to control the use of anonymised patient data by drugs companies because of concerns that their use of the information to market their products to GPs would lead to unneccessarily high prescribing bills. Lord Hunt made it clear that the government was reluctantly prepared to back down over the clause because it had received assurances from the pharmaceutical industry that it would use the data "responsibly". He said: "We will not hesitate to take action, including legislation should that prove neccessary in the future to protect the NHS and its clinicians from unacceptable commercial pressures." Lord Hunt rejected opposition arguments that proposals to give the health secretary power to sanction use of confidential patient information in the public interest would drive a "coach and horses" through the "established order of medical ethics". But he outlined plans to set up a statutory advisory committee to strengthen the safeguards against potential abuse of the powers.
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