Reforms will weaken health service accountability
pharmafile | June 1, 2011 | News story | Sales and Marketing | NHS reform, king's fund
The government has received yet more unwelcome news on health policy with a leading think tank warning its reforms will further weaken the quality and efficiency of the NHS.
The King’s Fund is the latest organisation to put the boot into the much-criticised Health and Social Care Bill, saying that it will reduce centralisation but fail to offer local accountability – one of the coalition agreement’s main pledges.
The Fund has issued a report following the end of the government’s six-week ‘pause’ in the process to listen to views on the Bill.
GP consortia are set to replace Primary Care Trusts and will look after £60 billion of taxpayers’ money, but the new report says there are only limited measures to stipulate how they should be made up and accountable to the public.
The think tank says more robust governance arrangements for GP consortia are needed, including a properly constituted board.
The report also finds that the new health and wellbeing boards – tasked with ‘joining up’ the efforts of GPs, local authorities and other local services – have “very limited powers” to hold GP consortia to account.
It urges stronger powers for them, with the new NHS Commissioning Board required to intervene if boards are not satisfied with the commissioning plans drawn up by consortia in their area.
The Fund says that reducing the role of Monitor in looking after foundation trusts could also mean hospitals are less accountable too.
It suggests that foundation trust boards and governors will need more support in overseeing the performance of hospitals and the actions of senior staff.
Deputy prime minister Nick Clegg has already signaled that the Bill could be sent back to repeat its committee stage in the House of Commons in order for MPs to debate the new changes.
“The pause in the legislative process provides an opportunity to look again at these issues,” says Anna Dixon, director of policy at The King’s Fund.
The goal should now be to “strengthen accountability in the health system to drive improvements in performance and ensure that public money is well spent”, she adds.
If these issues are not sorted out, the Fund concludes, there may be a future need for greater government intervention, thus negating the point of the reforms, which was to reduce ‘top-down’ management.
Health secretary Andrew Lansley had hoped to speed the Bill through Parliament but there has been vocal opposition from groups such as the BMA and Royal College of GPs, who want PCTs to remain.
The government will now review all of the responses to its consultation, and consider how best to proceed with its reforms. Some are arguing that the need for change to the existing bill is so great that it should be scrapped, while others are urging for it to be pushed through with amendments.
Adam Hill
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