NHS reforms will be accelerated, Milburn tells GPs

FAMILY DOCTORS' leaders were warned yesterday by the new Secretary of State for Health not to oppose a big expansion in walk-in primary care clinics and the telephone helpline NHS Direct.

FAMILY DOCTORS' leaders were warned yesterday by the new Secretary of State for Health not to oppose a big expansion in walk-in primary care clinics and the telephone helpline NHS Direct.

In his first full day in office, Alan Milburn delivered an uncompromising message that the pace of change would be stepped up. He echoed Tony Blair's Labour Party conference speech by attacking "forces of conservatism" in the health service.

Mr Milburn, in effect, warned the British Medical Association that it was heading for a confrontation if it continued to oppose the pace of change which has seen the introduction of NHS Direct, the 24-hourhelpline staffed by nurses, walk-in clinics, and the replacement of GP fundholding with primary care groups.

"There will always be forces of conservatism in the NHS and elsewhere," he said. "But there is a modernising, radical agenda for the NHS which I am determined to pursue because, quite simply, the NHS can't afford to stand still."

The BMA responded last night by asking for urgent talks with Mr Milburn.

Ian Bogle, chairman of the BMA Council, said: "I am yet to be convinced that, at the speed it is going and without evaluation, this is money wisely invested.

"I am not totally convinced by the argument that, in the days of convenient shopping and convenient banking, the health service is able to or should deliver a 24-hour routine service. It is not correct to say that either the BMA or doctors are opposed to changes in the NHS."

Ministerial sources said Mr Milburn was aiming his criticism at doctors' leaders rather than at NHS staff, who supported the changes. "The key message is they had better get used to it, because there's going to be a lot more of it," said one source.

The BMA is demanding that further change should be slowed down, and ideas such as walk-in clinics should be tested in pilot schemes before being adopted nationwide.

Mr Milburn's remarks will be seen as a clear indication that he has been given a brief by the Prime Minister to accelerate the pace of change, and that this week's reshuffle was designed to speed up Mr Blair's efforts to modernise public services.

Visiting a London cancer unit, Mr Milburn, regarded as an arch-Blairite, paid tribute to his predecessor, Frank Dobson, for "laying the foundations of a modern NHS".

But the Secretary of State added: "Now is the time to build on those foundations by upping the pace of change.

"Those who say that the pace of change is already too fast misunderstand the mood of patients and staff in the NHS. Modernisation is here and it's here to stay."

He continued: "The world is changing fast and the public are impatient for change. They want a faster, more convenient health service, better attuned to the needs of the modern world." He also called for an end to demarcation lines between "health and social care, primary and secondary care and between clinical professionals, too".

In his previous role at the Treasury, Mr Milburn played a key role in drawing up "public service agreements", designed to ensure that extra money for hospitals and schools was tied to efficiency improvements. As Mr Dobson's minister of state for health after the 1997 election, Mr Milburn was responsible for the changes now being resisted by doctors' leaders.