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Health secretary Andrew Lansley has defended reforms to the health system against claims that GPs could receive banker-style bonuses and that waiting times had increased for patients.
Lansley said that measures introduced in the Health and Social Care Bill, published last week, will give GPs a greater role through commissioning treatment, leading to improved services across the NHS.
Under the plans, GPs will be placed in charge of almost 80 per cent of the NHS budget, to commission services for patients from 2013.
During questions in the Commons, shadow health secretary John Healey criticised the measures for GP consortia, suggesting it would not be possible for GPs to be both family doctors and commission services.
He said: "If they are going to carry on being family doctors then planning, negotiating, managing and monitoring hundreds of commissioning contracts is not going to be done by GPs, it'll be done in their name, either by the people doing it now in primary care trusts or by big health companies that are already hard selling this service to new GP consortia.
Healey suggested that the "true purpose of the changes was to open up all parts of the NHS to big private healthcare companies."
The shadow health secretary said that changes to GP commissioning were motivated by "hard-line political ideology" as opposed to patient care.
He added: "Isn't this NHS reorganisation like an iceberg, with the substantial ideological bulk being kept out of public sight?"
Lansley said the purpose of the Bill had been very clear, to "improve quality and raise standards throughout the health service".
He said that putting clinical leadership at the "heart of the reforms is essential", with leadership not being the same as management.
"We are going to support them in taking clinical leadership in designing services for patients and bringing the best management support to bear in doing that," Lansley told MPs.
He insisted that the changes would ensure a level playing field for competition instead of favouring the private sector.
Winner of this month's Oldham East and Saddleworth by-election, Debbie Abrahams asked why when frontline NHS staff were fearing for their jobs, the NHS Commissioning board was being allowed to make bonus payments to GP consortia.
In her first question in the Commons, the Labour MP asked: "Isn't this the worst kind fo excess? We don't want to see it in out banking system, we certainly don’t want to see it in our NHS."
Lansley said that GP has been partially remunerated through a quality of outcomes method for several years.
He said the principle being that if they deliver better outcomes for patients they should have a "corresponding benefit from doing so".
"The commissioning consortia, in the same way, if they deliver improving outcomes for patients that should be recognised in their overall reward as well."
Shadow health minister Diane Abbott noted the comments from the House of Commons health committee who had expressed "surprise" at the pace and scale of reforms set out in the health white paper.
In response, health minister Simon Burns assured that the government would respond to the committee report shortly
Labour MPs attacked other aspects of the reforms, claiming that cuts in spending had already led to longer waiting times for patients.
Shadow health minister Derek Twigg said patients had been happy with the NHS in its "current form" and that waiting lists had been increased, with "more and more operations" being cancelled or postponed in hospitals.
He said: "If you are confident of the health secretary's plans for the NHS, would you guarantee that under the plans for the NHS that hospital waiting times will not rise or are you going to duck the question like the prime minister did last week?"
In response, Burns said that under the reforms, a focus on raising quality and outcomes will provide "improved quality healthcare for patients".
He said that under the reforms he could guarantee that not only are people getting improved quality but they will also see quality times based on the clinical decisions "rather than distorted by political processes".
Former Cabinet minister Ben Bradshaw suggested that under the coalition, the NHS was already struggling to meet targets on waiting times due to cuts in spending.
He called for confirmation that waiting times had increase, with some people already waiting more than 18 weeks and that the performance of accident and emergency departments had "deteriorated since watering down A and E target."
Burns told the Exeter MP that his comments had been incorrect.
The minister said current average waiting times were just over eight weeks, with the government focused on ensuring patients are satisfied with the standard of treatment they received.
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