NHS Reforms Attacked By BMJ & Lancet Following News Of £1.7 Billion Reorganisation Fund

NHS Reform Plans

Earlier in the week the Health Secretary, Andrew Lansley, announced plans for radical changes to the way the National Health Service works in a white paper titled ‘Equity & Excellence: Liberating the NHS’. If fully implemented the changes will see:

  • All 10 Strategic Health Authorities (SHAs) abolished
  • All 152 Primary Care Trusts (PCTs) abolished
  • General Practitioners (GPs) given responsibility for managing hospital, mental health & community services
  • Patients given more performance related information by a new body called HealthWatch
  • Patients given control of their Medical Records
  • All NHS Trusts achieve Foundation Status by 2013

The abolition of Strategic Health Authorities and Primary Care Trusts will affect more than 60,000 managers and in their place hundreds of GP consortiums will be created and given the responsibility for much of the £105bn health budget. The bottom up rather than top down reorganisation has been called ‘the most radical change in NHS history’.

Cost of Restructuring may Spiral

One of the major long term aims of the restructuring is to achieve significant cost savings by removing layers of bureaucracy in the form of Strategic Health Authorities and Primary Care Trusts. On Monday the Health Secretary said that the reforms would see management costs (currently standing at £1.85 Billion) cut by 46% over the next four years (a saving of £850 million).

Due to the scale of the changes many experts believe that costs will spiral out of control. In the British Medical Journal one expert said that the current £1.7 Billion fund could end up increasing to £2-3 Billion. While in the Lancet Kieran Walshe, professor of health policy at Manchester Business School said the reorganisation is likely to cost up to £3bn to implement with no guarantee that it will improve performance or lead to better care for patients.

James Gubb, a health expert at Civitas (a think tank), said that \”This is a huge change and will take a lot of money to achieve because new organisations and frameworks have to be set up, staff laid off and new people recruited. The risk is that it ends up taking the NHS away from what it must do – becoming more efficient. Past experience of restructures suggests it could set the NHS back between one and three years.\”

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