Risk register spells out NHS reform risks
pharmafile | March 27, 2012 | News story | Sales and Marketing | NHS reforms, commissioning, health bill, risk register
A leaked document that assesses problems with the government’s reform of the NHS has been published by the Guardian.
The document, written up by civil servants, warns that GPs are not ‘sufficiently developed’ to run the clinical commissioning groups, and says that emergency care will be less managed due to the ongoing restructuring of the NHS.
It also says that there is a high risk that there will be ‘unhelpful conflict and creative tension’ between the NHS Commissioning Board and Monitor, the new economic regulator established to encourage competition in the NHS.
The document is a risk assessment of the government’s Health and Social Care Bill, that will remove the current Strategic Health Authorities and Primary Care Trusts in England, replacing them with GP-led clinical commissioning groups.
These will be responsible for commissioning around £60 billion of the health service’s annual budget from next year, with the remaining £45 billion being the responsibility of the Commissioning Board.
The document says that this restructure poses a high risk to the NHS as the new GP groups may be forced to go bust or cut services to make ends meet.
It also says that GPs may be have to become managers ahead of being clinicians, which could affect care of their patients.
This is a draft form of the risk register that was written up in September 2010, two months after the government’s White Paper on the reforms were published.
The final ‘transition risk register’ was drawn up several months later on 10 November 2010, but this has not yet been released.
Since then the Bill has been heavily amended, after the government was forced to ‘pause’ the transition of the Bill through parliament, due to growing anger about the reforms.
The Bill is expected to be passed into law this week and now only awaits Royal Assent, the final part of the parliamentary process.
The government has been fighting to keep its risk assessment of the reforms away from the public, as it was concerned about the negative image it could give.
Labour forced a Commons debate on the issue last week, arguing that it should be published before the Health and Social Care Bill becomes law, but the Opposition party was defeated by a comfortable majority.
Andy Burnham, the shadow health secretary who led the Commons debate, said: “Now we know why [prime minister] David Cameron refused to publish the risk register before the Bill was through parliament – it’s because civil servants were telling him his reorganisation was likely to cause major damage to the NHS.
“David Cameron will never be forgiven for knowingly taking these risks with the country’s best-loved institution.”
The risk register was leaked to the health writer Roy Lilley, who will speaking at the Pharmafocus Medical Education in Practice event on 18 April.
Ben Adams
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