NHS faces its toughest ever year
pharmafile | January 5, 2011 | News story | | BMA, NHS, NHS Confederation, NHS White Paper, NHS reforms, clinical commissioning
Doctors leaders and healthcare managers have used their New Year messages to warn of hard times in 2011 for the NHS.
The NHS Confederation said the 62-year old health service could be about to face its toughest ever year as it grapples with a huge series of reforms and faces an ambitious efficiency drive.
The Confederation’s acting chief executive Nigel Edwards said: “I want to be clear from the outset that we support the objectives of the Government’s healthcare reforms. Indeed, there are good reasons to believe health systems work better where budgets and spending power are as close to patients as possible.
“But there is no escaping the conclusion that 2011 will be really tough for the NHS, possibly the toughest year it has faced. If the issues are not fully recognised, they will be dealt with poorly and patients will be the losers.
“The NHS is going to have to get all hands to the pumps and it will need all the help it can get. We need policy makers to fully understand the pressures, to act to mitigate the risks and to persuade those involved that we are on the right course.”
The White Paper outlining the next stage of NHS reforms is set to be brought before the House of Commons later this month for ministerial scrutiny.
It aims to put GPs in charge of clinical commissioning, giving them 80% of the £105 billion NHS budget and scrapping the current management system of PCTs and SHAs.
“Some say the health bill will be the biggest piece of legislation that the Department of Health has ever produced,” Edwards said. “That would not surprise NHS managers who are wading through the 1,500 pages of healthcare policy published by the Government in December alone.
He added that Parliament would have to come to grips with whether the reforms will be powerful enough to achieve their targeted goals.
“For instance, it’s easy to support giving patients more choice and comparative information on services, but will that actually drive significant improvement in the quality of care?”
Edwards also suggested the reforms could transform the NHS into an organisation that more closely resembles the UK’s water, electricity and gas industries.
“Be in no doubt, the plans are radical,” Edwards said. “In 1948, the NHS was a centrally planned and managed organisation. Today it is more a loosely connected system of organisations.
“Under these plans, it will become like a regulated industry similar to the utilities. That could trigger major reshaping of the way care is delivered, with services closing and changing.”
The utilities industry was privatised in the early 1990s for England and Wales and a series of regulators established to maintain competition in the market.
The NHS will itself will be subject to an ‘economic regulator’ in the form of Monitor that, under the reforms proposed by the NHS White Paper, will enforce competition within the NHS for services.
NHS to be ‘tested to the limit’ by reforms
Meanwhile the BMA’s leader Dr Hamish Meldrum used his New Year message to say that 2011 would be a “defining year” for the health service and one in which the NHS will be “tested to the limit”.
Meldrum said that the government’s response to its consultation on the White Paper was a “missed opportunity” to demonstrate to doctors and patients that it was listening to the concerns that many had put forward.
“Whilst we support proposals to increase clinical involvement in the design and delivery of healthcare, enable greater public and patient involvement and put the focus on quality and outcomes, rather than crude targets, we have real concerns about other aspects of the planned reforms,” he said.
“In particular, the lack of detail in many areas, the increasing emphasis on competition and the market, and the significant risks created by the process of rushed and unnecessarily risky transition, particularly at a time of such financial stringency.”
Ben Adams
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