MPs hit out at NHS reforms
pharmafile | January 18, 2011 | News story | | GP consortia, Health Select Committee, NHS, NHS reforms, PCTs
MPs have come out against the NHS White Paper, saying it has caused wide spread uncertainty at a time when the government should be focusing on meeting efficiency challenges.
A new report by the influential Health Select Committee outlines a series of concerns with the government’s planned reforms of the health service.
Chief among them is its need to meet the ‘Nicholson Challenge’, after the 2009 report by NHS chief executive Sir David Nicholson that requires the NHS to make £15-20 billion in efficiency savings over the next four years, while subsequently gaining only a 0.1% increase in real terms funding.
The MPs said that at a time when the primacy of the Nicholson Challenge should have “focused the minds of NHS senior management” on securing “unprecedented efficiency gains”, there is instead evidence of “widespread uncertainty” about the government’s intentions.
The Committee believes this will have the effect of “blunting” the ability of the NHS to respond to the Nicholson Challenge.
The Health Select Committee’s report is published on the eve of the government’s Health and Social Care Bill, which will tomorrow provide the next step towards enacting the White Paper’s changes.
Published in July, the White Paper proposes removing the current management system in the NHS and replacing it with regional GP consortia.
These consortia would then control the £80 billion budget once held by Primary Care Trusts and Strategic Health Authorities and be responsible for clinical commissioning across the NHS by 2013.
An NHS Commissioning Board, which will be headed by the current NHS chief executive Sir David Nicholson, will gain responsibility for the day-to-day running of the health service.
The MPs in the Helath Select Committee also questioned the ‘surprise’ approach of these reforms, saying that although it was not necessarily wrong to spring them on the NHS, such a strategy requires clarity and planning – something they doesn’t believe is reflected in the White Paper.
PCT concerns
The Committee noted too that the concerns over the immediate future of PCTs between now and their abolition in 2013/14 has seen both morale and staff start to shrink.
Nicholson and the Department of Health have now decided to establish PCT ‘clusters’ to support each other and the emerging GP consortia, something the Committee acknowledges as “pragmatic response” to an unexpected situation arising from the White Paper.
Consequently the report recommends PCT clusters should be in place by 1 April to ensure that they are able to “manage the delivery of the Nicholson Challenge”.
In terms of the future of commissioning, the report said the development of pathfinder consortia represents a further “important step” in clarifying commissioning responsibility.
But the Select Committee remains “very concerned” that a timescale which involves a further 15-month delay in establishing full coverage represents a “serious risk to the quality of commissioning decisions” during that period.
The MPs added that these changes have taken place in advance of Parliament having the opportunity to debate and approve them, something they believe is “unsatisfactory”.
“However, given that these changes have been made, it is important that they are put in place as quickly as possible in order to ensure that the system is managed effectively,” the report concluded.
Ben Adams
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