Cameron outlines NHS Bill changes

Amendments included altering the make-up of commissioning consortia, the retention of some current waiting time targets and the role of regulator Monitor.

The 18-week limit on waiting lists and four hour waiting limit for A&E will be retained.

However, this was tempered by the PM who acknowledged that this target had caused disruption to many patients in its implementation, and so outcomes such as re-attendance rates for the same problem would also be measured.

The use of GP-only consortia to commission NHS services was one of the main points of contention surrounding the original form of the Bill.

But David Cameron announced that hospital based doctors and nurses would be involved in the consortia commissioning NHS services alongside GPs.

And he added that these groups would only take over when they were ready, rather than by 2013 as previously timetabled.

Clinical senates monitoring the integration of NHS services over a wide area will be formed bringing together groups of doctors and healthcare professionals.

Monitor will also have a duty to promote integration of care but it's main duty will remain the use of competition to protect and promote the interests of people who use health care services.

The Prime Minister also acknowledged the need for the consultation exercise, saying: "We recognise that many people have had concerns about what we were doing."

But he concluded with a warning about the rising costs of funding the NHS and the problems this would cause.

"We can't pretend that the extra money we are putting in will be enough to meet the challenges," he said.

"We need modernization of the NHS to do that and we need to reduce the demand for healthcare, which is why we are prioritising public health.

"And we need to make the supply of healthcare more efficient, which is why we are opening up the system to new providers and putting clinicians in control," he added.