Reforms may undermine NHS cost savings, say MPs
pharmafile | April 27, 2011 | News story | | NHS, NHS reform, Public Accounts Comittee
Radical reforms to the NHS in England could undermine the drive to save £20 billion over the next four years.
This is the conclusion of a new report by MPs in the Committee of Public Accounts, which focuses on value for money and accountability across public spending.
The reforms, introduced by health secretary Andrew Lansley, will see the current regional PCT and SHA bodies scrapped and replaced with new GP consortia.
The report says: “The one-off costs and disruption of reorganisation at the same time as seeking £20 billion efficiency savings provides an additional challenge to the NHS.”
It also added that it is currently unclear who will be in charge of the NHS once the reforms are complete. “Parliament, and this Committee in particular, needs certainty about who to hold accountable for health spending once the reforms are complete,” it says.
The committee says it is concerned that the new GP consortia will not be sufficiently transparent or accountable, and could prove to be more inefficient than the existing PCTs.
The Committee’s concerns echo those of many groups, which have led to health secretary Andrew Lansley announcing a ‘pause’ in the progress of the reform legislation in early April. The government says the two month consultation is likely to produce significant changes to the plans, but hasn’t specified what these will be.
Among the many areas of concern raised by the report is the relationship between GP consortia and the new Commissioning Board, to be headed up by current NHS chief executive David Nicholson. The MPs fear that the organisational distance between the Board and the many consortia will prove too great, leading to lack of accountability and inefficiencies.
Health secretary Andrew Lansley responded quickly to the Committee’s report, saying the plans for reform and the cost saving programme were now aligned.
“The efficiency challenge and our reforms are inextricably linked. Our reforms help the NHS make savings, because getting rid of tiers of bureaucracy will mean an extra £1.7 billion each year to reinvest in patient care,” Lansley told the BBC.
“And if we don’t give doctors and nurses the power to make decisions for their patients, then quality of care will suffer,” he added.
But doctors’ leaders said the Public Accounts Committee was right to highlight the risks posed by such a massive restructuring at a time of ‘financial crisis’ within the health service.
Dr Hamish Meldrum, chairman of council at the BMA, said: “We share the concerns of the PAC that the consequences of increasing competition in the NHS have not been fully addressed.
“‘Market failures’ in healthcare have far more serious consequences than in other industries – and may have little connection with quality of care, or even patient demand.”
Ben Adams
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