Surveys suggest that the great majority of us are still hazy about the Government’s highly-controversial NHS reforms. Health Editor Barry Nelson tries to answer some of the questions you may have.

WHY does the Government want to reform the NHS – is it not one of the most effective and efficient health systems in the world?
The author of the reforms – Health Secretary Andrew Lansley – has been studying and thinking about the NHS for many years, firstly as the long-serving shadow health secretary and, since May 2010, after he took over at the Department of Health.

He came to the conclusion that the NHS was unnecessarily top-heavy in its organisation and it would be in everyone’s interests – from the taxpayer to the patient – to simplify it.

Mr Lansley came up with the idea of cutting out the middle man, allowing decisions about the planning of health care to be taken, not by local NHS civil servants, but by groups of GPs.

This radical approach has been enthusiastically endorsed by a minority of GPs, who are keen to exercise more control over NHS budgets, but most family doctors seem unenthusiastic about the reforms and appear to be simply going along with what is expected of them.

Mr Lansley also believes that the streamlining of the NHS could free up billions of pounds for patient care at a time when the cost of the NHS is growing fast. The Health Secretary believes these resources can be spent more wisely by clinical commissioning groups, committees of GPs, nurses, hospital doctors and other NHS clinicians.

His hope is that resources will gradually be switched away from the acute hospital sector to the non-acute community sector, helping to prevent hospital admission and encourage more elderly people to be cared for in their own homes.

What changes have already taken place in the NHS in the North-East and North Yorkshire?
Clinical Commissioning Groups, or CCGs, have now been set up across the region.

These are mostly made up of family doctors, plus a small number of other NHS health professionals, from hospital doctors to community nurses.

In April next year, if the Health and Social Care Bill presently going through the House of Lords becomes law, about 70 per cent of NHS budgets will be transferred from the old primary care trusts (PCTs) to the new CCGs.

Currently, local health managers working for PCTs use the funds to plan and buy services for patients, including hospital care, community clinics and mental health units.

But on April 1, the new CCGs will take over this function. It is expected that the new planning groups will employ some of the NHS health planners who were made redundant from the old PCTs.

Services such as dentistry and specialist care – ie children’s heart surgery – will be the responsibility of a new national commissioning baord being set up to oversee the new-look NHS.

The regional Strategic Health Authorities will also be phased out and the main responsibility for public care switched to local councils.

Is the Government going to privatise the NHS?
The idea that private companies will play an increasing role in delivering health care for the NHS is a political hot potato.

Campaigners, such as cancer specialist Dr Clive Peedell, from The James Cook University Hospital, in Middlesbrough, are convinced that the Government’s proposals will destroy the traditional collaborative spirit of the NHS and encourage more competition.

Dr Peedell also believes that private companies will siphon-off funds from the NHS because they need to pay dividends to shareholders.

But Mr Lansley argues that competition is a positive thing and by inviting private companies, charities and voluntary groups to bid for NHS contracts, this could actually improve the quality of care for patients.

The last Labour government encouraged private companies to set up so-called independent treatment centres to tackle specific and limited problems, such as long waiting lists for hip and knee replacements. While waiting lists were rapidly cleared, there was criticism that NHS funds were wasted because some companies were over-paid for the number of patients actually treated.

Will the proposed changes cost very much?
The Government has said it believes that the cost of the changes will be outweighed by the economies achieved once the reforms are in place.

Certainly, it is thought that more than 20,000 NHS managers and administrators will be made redundant from PCTs, regional health authorities and the Department of Health.

So far, the Government has estimated that the reduction in staff will save the NHS about £5bn by 2015. But the bill from these changes could cost the taxpayer more than £1bn in redundancy payouts, not to mention the estimated £400m cost of setting up the new CCGs.

Are the proposals supported within the NHS?
While it is difficult to find out what rank-and-file NHS staff think about the plans – because no one wants to criticise their employer too much – it is clear the reforms face widespread opposition.

The British Medical Association, the Royal College of Nursing and the Royal College of Midwives have called for them to be withdrawn.

Last Friday, members of the Royal College of Paediatrics and Child Health joined the Royal College of GPs in calling for the Bill to be scrapped, while the unions, Unison and Unite, are similarly opposed to it.