Parties clash over NHS cuts

By Steve Nowottny

A face-off between health secretary Andy Burnham and the two men who want his job has centred on a heated debate over how to make efficiency savings in the NHS - and a 'secret report' urging cuts in GP consultation times.

The role of the private sector also came in for particular scrutiny as Mr Burnham, Conservative health spokesman Andrew Lansley and Liberal Democrat health spokesman Norman Lamb traded blows over how patient care could best be protected in the face of projected NHS efficiency savings of £15 billion to £20 billion by 2014.

Mr Lamb directly challenged Mr Burnham to publish a controversial report drawn up by management consultancy firm McKinsey which recommended NHS London consider a series of radical cost-cutting measures including slashing GP consultations by a third, cutting the number of people going to A&E departments by 60% and shifting millions of patients into polysystems.

He said: ‘The changes in London are based on a report by McKinsey that has remained private. It is a secret report. This should be in the public domain – will you publish the report?'

But despite being repeatedly challenged on the point, Mr Burnham refused to explain why the report remained secret, claiming that publication was ‘not my decision'.

Mr Lansley pledged that under a Conservative government ‘every penny of the efficiency savings will be reinvested in the NHS', and said cutting administrative costs would be a priority.

But he added that the efficiency savings targets set by NHS chief executive David Nicholson should not be considered unreasonable.

‘What he's asking for is maybe 3% efficiency savings each year. In most areas of private sector activity that would be regarded not as ambitious.'

Mr Burnham insisted that lessons had been learned from the handling of the NHS's previous financial crisis in 2006-7, and said a 30% reduction in management spending would help.

‘We're going to have to have big savings on management costs in the NHS so we can carry on protecting the frontline,' he said.

But Mr Lamb warned that the previous financial crisis had prompted cuts in public health programmes, staff training and mental health - and cited Pulse's survey of GPs earlier this week as proof that frontline services are being cut once again.

‘Our choice now is whether you slash and burn services, and lose staff and training, which we're already starting to see the start of in various parts of the country,' he said. 'Pulse did a report yesterday demonstrating that this is what they're finding.'

Mr Lamb also buttonholed Mr Lansley over a donation his private office received from the wife of the chief executive of private company Care UK, arguing it was a ‘conflict of interest'.

Mr Lansley replied: ‘An individual person provided money to Conservative central office. That happens.'

BMA chair Dr Hamish Meldrum took all three politicians to task over the parties' commitment to increasing use of the private sector in the NHS.

‘There also seems to be a consensus amongst all three parties that although you're pledged to maintain NHS funding and to protect frontline services, you'll continue to push for NHS care to be delivered by competing commercial organisations - despite the evidence that this leads to fragmentation, loss of accountability, increased costs and that three quarters of the public don't want it,' he said.

Andy Burnham, on the need to take tough decisions and in some cases close hospital departments: ‘The NHS will have to make these kind of decisions in this next decade but I'm afraid both of you are trying to have it both ways.'

Andrew Lansley, on his pledge for a real terms increase in NHS funding: ‘We cannot make the sick pay for Labour's debt crisis'

Norman Lamb, on the need for greater clinical and public engagement in service redesign: 'I think we've tested to destruction the argument that you can impose change from on high.'

Click here to view a video of the full debate