The NHS reforms are at risk of forgetting the fundamentals of healthcare and throwing the baby out with the bath water, ministers and healthcare officials have warned.
A Westminster Health Forum heard this was the third time legislation of this nature had been proposed since the 1990s but there were fears the implementation of reform was blasé.
“It’s easy to overstate the importance of this piece of legislation and a mistake to focus on the legislation rather than the underlying challenges of the NHS,” Stephen Dorrell, chair of the Health Select Committee and former Secretary of State for Health, said. “We have to deliver 4% efficiency gain over four years – you can fix the budget but you can’t change the level of demand.”
He called it “frustrating” that there was a tendency to focus on the needs of a small minority of patients where care was uncomplicated while ignoring the needs of the vast majority of patients who required extensive health and social care.
Furthermore, Dorrell said the reforms should be looking at a requirement to deliver a more integrated service – a health and social care system rather than the NHS – and he proposed single budget commissioning across health and social care to achieve this. “If we don’t have one single budget commissioner then we won’t meet the objectives of efficiency and quality.”
Liz Kendall, Shadow Minister for Care and Older People, also argued against the bill saying the reforms would not help the NHS meet its challenges. “To try and do a massive reorganisation in the face of huge financial challenges is, I don’t think, the way forward.”
She warned that already services on the ground were moving into “danger zones” in response to the reforms and feared a situation where patients would soon be asked to pay for care.
Dr Clare Gerada, chair of the Royal College of General Practitioners, agreed there was a risk of losing sight of the bigger picture. “GPs face an enormous challenge to make clinical commissioning work but there is a danger we forget the role of GPs as providers of care.”
Meanwhile, David Stout, deputy chief executive of the NHS Confederation, noted there was a lot of uncertainty and a number of risks with the reforms, including the potential for decision making to become stagnated. However, he added, the NHS needed to adapt. “No change is not an option. If we don’t change then we will die by death of a thousand cuts – these salami slicing solutions will cut quality.”
The speakers agreed further reviews and more debate was required over the reforms and all stakeholders needed to be involved in the process as trusted partners.