The government should reconsider the speed and scale of its proposed health reforms if they are to deliver benefits to patients and improve NHS performance, according to The King’s Fund.
In its response to the government’s White Paper – Equity and Excellence: Liberating the NHS – the health policy think tank says it supports the need for reform but asks why a fundamental reorganisation of the NHS is necessary, when evidence shows that health outcomes and public satisfaction have improved in recent years.
“There are areas where NHS performance needs to improve and we support many of the proposals in the White Paper, but we question the need to embark on such a fundamental reorganisation as the NHS faces up to the biggest financial challenge in its history,” said the Fund’s chief executive, Professor Chris Ham.
The government proposals which the Fund supports includes giving general practitioners (GPs) a stronger role in commissioning services, extending choice for patients and enhancing the role of local authorities in the health system. However, it urges Ministers to think again about their plans for implementing the reforms, and identifies a number of areas where it believes a more measured approach could ensure the reforms deliver real benefits.
For example, it recommends moving quickly to work with GPs who are ready to embrace GP commissioning, giving them “real” budgets for some services as soon as possible and using their experience to inform the national roll-out, rather than imposing the GP consortia model in all areas of the country by 2013.
In addition, it says, NHS structures should be streamlined over time as new GP consortia get up to speed, instead of abolishing Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) in 2013, and it also calls for balancing the need for a regulatory framework that promotes competition to drive up quality while encouraging collaboration where services should be co-ordinated, for example in meeting the needs of older people and those with long-term conditions.
Meantime, leading health economist Nick Bosanquet has also called for PCTs to be retained for the foreseeable future and says they should be used as commissioning authorities to make best use of the relationships which they have developed with providers.
Speaking at a fringe meeting during the Conservative Party conference, Prof Bosanquet, who is professor of health policy at Imperial College London, condemned the proposed abolition of existing organizations and networks “at a time when we need more networks and at a time of great financial crisis.”
The current proposals will lead to “disaster” within about two years, when organizations will be faced with becoming insolvent or cutting services and when GPs are left struggling with financial deficits, Prof Bosanquet warned the meeting, which was organized by the Conservative Medical Society. He urged Ministers to rethink their proposals and adopt a “more realistic and focused implementation plan which keeps the PCTs.”
