The biggest shake up of the NHS since its formation comes into effect today. The aim is to make the NHS more accountable to patients and to release frontline staff from bureaucracy but critics warn the service is not ready for the major shake-up.
Labour has warned that transferring responsibility for tackling problems such as obesity and alcohol from the NHS to local councils - as part of an overhaul of the NHS - could be a "car crash".
In principle I support the handover of public health to local authorities. But in practice, because the Government has been so preoccupied with the wider NHS re-organisation, this handover could be a car crash.
The Government only announced the public health financial allocations a few weeks ago. This was far too late and has made it impossible for local authorities to plan properly.
The distribution has been blatantly unfair. The amounts per head of population will vary wildly, from £22 per head in Windsor and Maidenhead to £132 in Westminster. There is also no weighting towards the public health needs of children and young people, whose frontline services are already being cut in some areas.
It is wrong that this Government is unleashing this careless postcode lottery.
The NHS needs to change so that patients get the care they need, when they need it. From April 1 local nurses and doctors, who best know what their patients need will have the power, freedom and budget to decide what care and services are best for their local communities and how taxpayers' money is spent.
Patients will be able to choose who provides their care so everyday health checks like hearing and blood tests can be carried out at a time and place convenient for them, such as at a pharmacy on the high street instead of a hospital.
Health and care services will be better joined up by bringing together the NHS, local councils and patients. Patients will have a greater influence in changes to their local health and care services through the patient led inspections and the friends and family test.
Through these changes, the health service will improve, work smarter and, importantly, build an NHS that delivers high quality, compassionate care for patients.
Health experts have warned that NHS is "not ready" for the raft of changes implemented under the controversial health reforms - which come into effect today.
At one level patients won't notice anything dramatic on Monday morning. But the biggest thing that patients will notice will be the knock-on effect from the cuts in social care funding.
It is clear that our hospitals are already struggling to discharge patients. One manager who I spoke to last week said that 100 beds in his hospitals could be discharged if there was the care in the community.
Hospitals could cease to function and the system could grind to a halt because of people who do not need to be there.
– Professor Nick Black, London School of Hygiene and Tropical Medicine
GPs and Labour MPs have warned that NHS reforms due to take effect today will lead to a free-for-all for private providers.
In particular, new guidelines known as Section 75, are causing concern because they say that the award of a new contract without a competition can only happen:
...where the relevant body is satisfied that the services to which the contract relates are capable of being provided only by that provider.
– Section 75 guidelines
Critics say that in practise the phrasing means that new proposals can virtually never be given the go-ahead without competition from private providers.
That isn't the NHS that we've had for 65 years. There is huge disquiet across the medical profession about these regulations and the thought that they are going to be instructed to open every contract to full market testing.
The biggest shake up of the National Health Service in England, since its formation more than 60 years ago, comes into effect today.
One of the biggest changes is the move from primary care trusts (PCTs) to clinical commissioning groups (CCGs), which will be led by GPs and other clinicians who will take on responsibility for commissioning care.
The move will see 211 CCGs replace 151 PCTs across England. The CCGs will be supported by health professionals, such as local hospital doctors and nurses.
The teams will decide on which health issues are a priority in their area, and where to send patients for treatment in NHS or private facilities.
They will control around 60 percent of the NHS budget in England but will not be in charge of major services like complex surgery and rare cancers.