Dan Parton writes (13th April 2011) : Last week saw the government announce a 'pause' on proposedNHS reform and the launch of a "listening exercise", where healthworkers and the public will have the opportunity to comment on thegovernment's plans. And not before time. Ever since healthsecretary Andrew Lansley first announced plans for health andsocial care reform, last year, there has been widespread andsustained criticism. This intensified when the health and socialcare bill was announced in January. Indeed, the current poll on theLDT onlinehomepage tells its own story, with more than 81% of respondentsagainst the upcoming introduction of GP consortia. While it is onlya very small sample, it nonetheless reflects other polls that alsoshow a lack of enthusiasm for the proposed reforms. Chief amongthose concerns is that specialist services - such as those forlearning disabilities - may not be commissioned by GP's, who, beinggeneral practitioners, may not have the expertise - or thespecialist interest - to commission them effectively. There is alsothe wider issue of ensuring that people with learning disabilitieshave equal access to healthcare and are not discriminated against,and on which I haven't heard the government give any reassurances.Nevertheless, some of the initial amendments to the reforms thatthe government has announced, such as introducing measures to stopprivate health companies 'cherry-picking' the easiest cases, andoutlawing competition on price, suggest that at least some concernsare being listened to. But the Guardian reported that the government hassaid that certain aspects of reform - including GP consortia andthe abolition of PCTs - are not up for debate. However, if thisreally is to be a listening exercise, ministers have to appreciatethe concerns of staff and the people who use the NHS - particularlythose with an interest in specialist areas such as learningdisabilities. Fundamentally, assurances have to be given thatpeople with learning disabilities will not lose out as a result ofthe changes and that specialist services will be protected in areformed NHS. This includes ensuring that GPs have the relevantknowledge to effectively commission specialist learning disabilityservices. There should also be provision to ensure that people withlearning disabilities are properly represented in future governingbodies, such as the proposed independent commissioning board.Learning disability services have made great strides in recentyears and this progress must not be lost in any future reforms. Formore information go to: http://healthandcare.dh.gov.uk/