Controversial plans for the biggest overhaul of the National Health Service since it was created over 60 years ago have sparked huge political rows, and it all comes to a head in the House of Commons this week. In the first of two special reports, Health Correspondent Alison Dayani examines the details of the health reforms.

THERE have been radical ideas, pauses, U-turns, name changes and major adjustments to the new Health Bill, but this week it reaches its final approval in the House of Commons.

The biggest shake-up the National Health Service has ever seen has sparked a battle of epic proportions from unions, medics and politicians.

In one corner, Health Secretary Andrew Lansley, the man behind the health reforms, is confident his vision will give more power to patients and health professionals, create greater competition to the NHS to make it more efficient, while also cutting bureaucracy.

With the population growing, people surviving longer, advances in medicine raising expectations and a surge in elderly care costs, the NHS cannot continue to provide as we know it, the Government says.

In the other corner, health watchdogs, unions and campaigners are gathering force claiming the Health and Social Care Bill will send the NHS into instability and be the first step towards privatisation, similar to a system in America, where private companies are the winners.

The Bill needs to be voted through three readings in the House of Commons, after which it is passed on to the House of Lords for a three further readings, before it officially comes into being. Even opposition by the Lords will not be able to stop the Bill if it is supported in the Commons.

The third reading in the Commons takes place tomorrow.

But the Bill has been heavily changed since its earlier readings in January, as growing concern forced a two-month “pause” for a further review by leading medical professionals, who came back in June and forced over 180 amendments.

The current bill being discussed still sees the Health Secretary absolving responsibility for the NHS.

Instead, responsibility will be in the hands of an independent NHS Commissioning Board at a national level, and locally by Clinical Commissioning Groups.

The Clinical Commissioning Groups representing towns and suburbs of large cities will be left alone to manage their own finances and choose what patient services are necessary in the community and at hospitals instead of Primary Care Trusts and Health Authorities, which are being abolished.

These groups were originally called GP Consortia, but the name has been changed because although the majority of members will be GPs, the groups will also include and give power to nurses, consultants, councillors and health professionals such as dentists, pharmacists and opticians.

The move is aimed at reducing bureaucracy and managers by a third and will see these groups handling at least 65 per cent of the NHS budget, around £80 billion.

Public health will move under the responsibility of the local council, which will also set up Health and Wellbeing Boards, staffed by members of the public, to monitor what Clinical Commissioning Groups are doing and look at needs in the community.

Plus a new watchdog called HealthWatch is also being set up to ensure patients’ views are listened to.

But the most contentious issue surrounding the Bill is the push for more competition and private companies to get involved in the health service.

Current restrictions on how many private patients NHS hospitals can treat will also be lifted, raising fears that there will be a focus on putting rich foreign patients first as they bring in more money.

Under the plans, Clinical Commissioning Groups will be able to choose between hiring a qualified private company or a NHS trust to provide a service.

Mr Lansley said this greater competition will give patients more choice but has promised to introduce this at a slower rate than previously announced as part of amendments.

The role of Monitor, an overseeing body after the pause has been changed and it has been tasked with protecting patient interests and preventing a market “free-for-all” where private firms cherry-pick the most profitable services instead of promoting competition.

HOW THE REFORM WILL AFFECT  THE PUBLIC, HEALTH WORKERS AND HOSPITALS>>>>