14 June 2011 Last updated at 12:25

David Cameron is unveiling wholesale changes to the controversial NHS reform bill after an independent review criticised many of its key proposals.

The prime minister said the government had listened to fears about increased competition and more powers for GPs and would now slow the pace of change.

The Lib Dems opposed aspects of the bill and leader Nick Clegg said their demands had been “handsomely met”.

But Labour say the revisions do not go far enough to protect the NHS.

At a joint press conference with his deputy Nick Clegg and Health Secretary Andrew Lansley, Mr Cameron said those who described the revisions as “a humiliating U-turn”, or the listening exercise as “a big PR stunt”, were both wrong.

“The fundamentals of our plans – more control to patients, more power to doctors and nurses, less bureaucracy in the NHS – they are as strong today as they’ve ever been,” the PM said.

“But the shape of our plans, the detail of how we’re going to make all this work, that really has changed as a direct result of this consultation. ”

Mr Clegg said he hoped the government now had a plan “we can all get behind”.

“Change will happen, but it will happen at the right pace and that is why the arbitrary deadlines have gone,” he added.

Competition ‘diluted’

On Monday – following a 10-week “listening exercise” – a panel of experts called the NHS Future Forum gave its recommendations on the changes needed to the bill, which applies to England only.

The BBC understands many of those will now be accepted, including:

• The legal responsibility of the health secretary for the NHS to be reinstated
• The 2013 deadline for the new GP commissioning arrangements to be relaxed
• The power of health and well-being boards, which are being set up by councils, to be beefed up and patients given a greater role on them
• GPs still taking the lead in making decisions, but other professionals such as hospital doctors and nurses to be consulted more
• The focus on competition to be “significantly diluted”, with the regulator, Monitor, focusing on improving patient choice instead

A National Commissioning Board, based in Leeds, will be set up to control budgets until GP groups are ready to take over, but the BBC understands the government will not be explicit about whether or not all such groups in England will ever actually be compelled to do so.

The Department of Health says the aim and expectation is that all groups will take the powers on eventually, but sources admit that leaves the Lib Dems free to suggest that GP groups could ultimately refuse to do so.

The government and many health professionals believe changes to the NHS are necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes such as obesity.

Rifts within the government over the NHS bill have deepened since the Lib Dems’ very poor results in the May local elections.

Mr Clegg had vowed to block any proposals he was unhappy with – a move widely seen as an effort to reassert the power of the Lib Dems within the coalition – and on Monday night he was reportedly cheered by his MPs for his role in bringing about substantial changes to the bill.

He later wrote on Twitter that the revisions had made the bill “a whole lot better”, but added: “This is still a major reform of the NHS. We’ve never been against reform. We’ve always been in favour of the right kind of reform.”

Dr Hamish Meldrum, chairman of British Medical Association, said the government’s approach during the listening exercise had been “refreshing”, but this needed to be maintained in the coming months.

Professor Steve Field, the former head of the Royal College of GPs who led the Future Forum, said while the principle of putting doctors in charge was well supported, he had heard “genuine and deep-seated concerns” from many.

But, for Labour, shadow health secretary John Healey called the Future Forum report a “demolition job on the Tory-led government’s misjudgements and mishandling of the NHS”.