Government 'took concerns over NHS reform on board'
Unions, thinktanks and health campaigners have expressed doubts about the reforms, which will see primary care trusts (PCTs) and strategic health authorities (SHAs) abolished.
GPs will take hold of the purse strings from 2013, planning hospital care and services for patients.
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Hide AdSome 52 "GP consortia" have already signed up to manage their local NHS budgets, covering a quarter of the population.
But opponents have insisted the reforms are too speedy and could damage patient care.
Unite said today Health Secretary Andrew Lansley was driving the NHS into "the buffers" by moving too fast and without proper consultation.
The union, which has 100,000 members in the health service, said the plans were heading "in the wrong direction" and had been "cobbled together".
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Hide AdLater today, the Government will outline its priorities for the NHS in the coming year as part of the NHS operating framework.
Mr Lansley announced that part of it would include hospitals being "held to account" and fined if they fail to get rid of mixed sex wards.
In its response to the consultation on its white paper, the Government said it had listened to concerns about the structural overhaul of the NHS.
It has made some amendments, including placing commissioning of maternity services with GPs instead of with a National Commissioning Board.
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Hide AdIt has also pledged to "allow a longer and more phased transition period" for completing some of the reforms, such as keeping the regulator Monitor on board for some control of foundation trusts.
It has also promised to "create a clearer, more phased approach to the introduction of GP commissioning" through the pathfinder pilots.
"This will allow those groups of GP practices that are ready, to start exploring the issues and will enable learning to be spread more rapidly," it said.
The document said the Government will "increase transparency in commissioning by requiring all GP consortia to have a published constitution."
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Hide AdMinisters have also recognised "that our original proposal to merge local authorities' scrutiny functions into the health and wellbeing board was flawed.
"Instead we will extend councils' formal scrutiny powers to cover all NHS-funded services, and will give local authorities greater freedom in how these are exercised."
The document said the Government had listened but "disagrees" with concerns from groups including the think tank the King's Fund, the Royal College of Nursing and Arthritis Care that the scale of the reforms are too big, untested or are occurring at the wrong time.
Also today, PCTs were told they will receive a total of 89 billion next year to fund services.
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Hide AdOn mixed-sex wards, Mr Lansley said he was not prepared for hospitals to be paid for providing a "sub-standard" service and patients had the right to dignity and privacy.
"Our expectation is that all hospitals across the country should declare that they are now compliant with the criteria for only putting patients into single-sex accommodation, except where there is an emergency reason to do so," he told BBC Breakfast.
"Where they breach those rules, the point is we are not going to pay hospitals for providing a sub-standard service.
"We will make it clear in the new year that every hospital will report on their compliance with the new standards on single-sex accommodation.
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Hide Ad"Patients have a right to expect that they have dignity and privacy. If there is a breach of that, that too will be published, so everybody will be held to account for this."
The announcement on mixed-sex wards comes after governments have struggled for 15 years to end the practice of men and women sharing wards.
Mr Lansley said in August that it would be ended in all but accident and emergency and intensive care units by the end of the year.
Under his plans, hospitals face losing part of the funding for a patient if they have to share with the opposite sex unless they have consented to it - with those facilities failing to comply being named and shamed.
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Hide AdTUC general secretary Brendan Barber, said of today's announcements "The Conservatives would not even have a share of power if they had not promised to protect the NHS budget and stop top-down re-organisation.
"Yet today it's clear that there will be cuts, top-down organisation and privatisation by stealth as private companies increasingly run parts of a fragmented market-based NHS.
"And these 'reforms' are likely to cost two to three billion pounds at a time when health spending is being cut in real terms."
Unite's national officer for health, Karen Reay, said: "Andrew Lansley has not listened to the concerns of major health organisations, such as the Royal College of General Practitioners and the British Medical Association (BMA), and is pressing ahead with these ill-considered reforms which were cobbled together in just six weeks after the General Election.
"These 'reforms' have not been costed and are untested.
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Hide Ad"The result will be that the NHS hits the buffers and patient care will suffer during this expensive reorganisation, which is, in effect, an 'open sesame' to private healthcare companies to take-over the running of the NHS."