MPs have delivered a bruising ‘wake-up call’ to ministers, with a report concluding that the move to GP-led commissioning was undermining targets to cut NHS spending by £20 billion by 2014/15.
The House of Commons Health Committee report – widely trailed in the national newspapers over the week – says many health trusts are simply cutting services rather than finding savings by innovation and greater efficiency, despite assurances from health secretary Andrew Lansley that this would not happen.
The damning verdict on the Government’s Health and Social Care Bill – led by former Conservative health secretary Stephen Dorrell – has been welcomed by health commentators and managers.
The report on public expenditure by the panel of MPs said the NHS reform process ‘continues to complicate the push for efficiency’ and had caused ‘disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings’.
MPs said they had heard widespread concerns about trusts’ ability to meet their QIPP targets, saying: ‘We are concerned that there appears to be evidence that NHS organisations are according the highest priority to achieving short-term savings which allow them to meet their financial objectives in the current year, apparently at the expense of planning service changes which would allow them to meet their financial and quality objectives in later years.’
And on integration, the committee – which has a majority of Conservative and Liberal Democrat MPs, reports ‘precious little evidence of the urgency which it believes this issue demands – on both quality and efficiency grounds’.
It called for ‘underperforming commissioners [to be] held to account for failure to engage in this necessary process of change.’
John Appleby, chief economist at the King’s Fund, said: ‘The report should serve as a wake up call for ministers and the NHS about the magnitude of the task ahead.
‘Too much emphasis is being placed on finding short term financial savings instead of delivering real improvements in performance and productivity. This is a big challenge but there remain significant gains to be made by tackling unwarranted variations in NHS performance.’
Mike Farrar, chief executive at the NHS Confederation, said: ‘I would urge all MPs to take on board the findings of their own committee’s report and to back NHS leaders as they seek to drive the necessary changes.’
‘Anybody who thought the NHS was simply “protected” is sleep walking into some serious difficulties.’
Commenting on the report, Dr Hamish Meldrum, chair of the BMA Council, said: ‘We agree that a degree of reform is needed if the NHS is to be sustainable in the long term but we don’t need legislation to do that. We could still see the benefits of greater clinician-led commissioning, for example, without this Bill.’
‘There is still time for the Government to withdraw the Health and Social Care Bill – a bill which an increasing number of health professionals are opposed to – and work with healthcare professionals and others to agree a more pragmatic way forward.’