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Wednesday 23 May 2012
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Scrap the bill and save £1bn, Government told

By Andrew McNicoll | 31 Jan 2012

Scrapping the health bill would save the Government over £1bn in 2013 and give the NHS the stability to make improvements in ‘efficiency and productivity', according to an health policy expert.

Writing in the British Medical Journal, Professor Kieran Walshe, professor of health policy and management at Manchester Business School, claims that abandoning the Health and Social Care Bill would remove the need for the Government to establish the NHS Commissioning Board and other statutory bodies, saving the Government at least £650m in annual running costs and around £360m in set up costs.

He points out that the streamlining of PCTs into clusters is already delivering ‘most' of the £1.5bn a year in administrative savings the Government promised under the reforms.

Professor Walshe argues that scrapping the reforms would stop ‘the damaging period of prolonged organisational uncertainty in the NHS'. The stability would allow NHS organisations to ‘focus on what is the real and urgent problem for the NHS' – the need to sustain performance in economically straitened times.

Professor Walshe admits that abandoning the health bill ‘would be politically painful and damaging' for ministers, but argues that the Government might gain public credit by scrapping the controversial NHS reforms.

‘They might get some credit from the media and the public for listening and learning, but they would also neutralise an issue which has become increasingly politically toxic for them,' Professor Walshe adds.
 
‘They could then plan to accomplish much of their intended reform agenda – greater patient choice, more GP involvement in commissioning, increased plurality and competition in healthcare provision – using existing legislative provisions,' he concludes. ‘And the NHS could get on with delivering healthcare to patients, and the serious business of finding ways to do more with less.'

READERS' COMMENTS

Andrew Craig, Other healthcare professional,
31 Jan 2012
Reform of the NHS in England is inescapable. But it is also clear that a new Bill is needed, and quickly.

Stephen Dorrell and the Health Committee said clearly that the NHS is distracted with reconfiguration and structure (it's about their jobs after all). What people who work in the NHS should be focused on - at every level - is making the systemic changes to deliver better quality and more effective services to the right people in the right place at the right time. That is what QIPP (quality, innovation, productivity and prevention) is about and it's no joke. If we don't achieve these sorts of changes, no new structure is going to be affordable or effective and GP commissioners will sink without trace.

There is a clear "Plan B". Kieran Walshe's editorial in BMJ today talks about it and Roy Lilley has been banging the drum about it for months. We have the way forward for reform marked out clearly in the recommendations of the two Future Forum reports, all of which the present government has accepted with alacrity.

These reports constitute pretty much all that needs saying about what sort of NHS England needs. It is built on an understanding of needs and engagement with users and carers, the public, clinicians and managers. They are all in this together (to take back that hackneyed phrase).

The longer we delay shifting course in this direction, the worse the problems with the present system will become. No amount of baying across the floor of the House of Commons can disguise that. The time for blame is long past. And keeping things as they are now is also a recipe for disappointment and probably also bankruptcy.

The current Bill is a sow’s ear of legalese that no amount of tweaking is going to turn into a silk purse of convincing narrative for change. It has to go and be replaced by something that is comprehensible and which people in the health service and the public of course can all support.

There is a strong narrative for change that is simply not being heard clearly over the party political noise. If we do not act on that soon, there is a danger of straying into the wilderness so far that we cannot find our way back to reality.
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Anonymous, PCT,
01 Feb 2012
Andrew Craig's comments are very interesting although I think they will fall on the same stoney ground of Lansley's brain. I have to say (yet again) that no reorganisation will fully achieve its aims unless the PBR/choice/AQP environment is abolished.

PCT Finance Manager
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Anonymous, PCT,
01 Feb 2012
Alas the political imperative to save face and soldier on regardless will be seen as far more important than saving £1bn. A sad state of affairs but a true state I suspect
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