NHS reforms moving ‘too fast’
pharmafile | October 8, 2010 | News story | | NHS, government, king's fund
The government’s plans to reform the NHS are moving too far according to health think tank the King’s Fund.
Radical measures set out in the coalition’s July White Paper include putting doctors in direct charge of billions of pounds of the NHS budget and abolishing Primary Care Trusts.
“We question the need to embark on such a fundamental reorganisation as the NHS faces up to the biggest financial challenge in its history,” says King’s Fund chief executive Chris Ham.
The think tank says the government’s aims would be better served by building on existing arrangements rather than changing them wholesale.
The government wants to make GPs form groups that will then control chunks of the mental health, hospital and community services budgets.
But the King’s Fund suggests giving willing GPs money for some services now, and using their experience to test the water, “rather than imposing the GP consortia model in all areas of the country by 2013”.
It argues it should also be possible to promote competition to drive up quality, while encouraging collaboration on some services – for example, to meet the needs of older people and those with long-term conditions.
And it would also be better to streamline NHS structures “over time as new GP consortia get up to speed” rather than doing away with existing structures in three years’ time.
That is when the government wants to abolish England’s 152 PCTs and 10 regional Strategic Health Authorities – which between them handle 80% of the NHS’s £105 billion-strong coffers.
Under the White Paper plans, GPs are set to take on full financial responsibility from April 2013. An independent NHS commissioning board will allocate and account for NHS resources, but critics still worry doctors will spend more time balancing the books than treating patients.
The King’s Fund is concerned that large cuts in costs, at the same time as sweeping away PCTs and SHAs, will make it difficult to guarantee effective management of these proposals anyway.
“The coalition agreement published in May stated that there would be no further restructuring of the NHS, yet this is precisely what is happening,” said the thinktank.
“The case for reorganising the NHS needs to be clear and convincing to justify taking these risks, and this case has not been made,” it concludes.
Adam Hill
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