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Dorrell: Health bill merely a ‘footnote’ compared to £20bn efficiency challenge

Exclusive: The Government's reworked health bill remains largely irrelevant to the biggest challenges facing the NHS and will be seen as a historical 'footnote', Commons health committee chair Stephen Dorrell has told Pulse.



Mr Dorrell said he accepted the case for managerial change made by the bill, but warned that much more fundamental reform to 'radically change' the delivery of health services was required to ensure patients continue to receive high-quality care.

His views were backed by GP leaders addressing the health bill committee yesterday, who said opportunities to save money and improve care through integration were being missed by the NHS reforms.

Mr Dorrell said that despite the current debate over the health bill, the legislation would be remembered merely as a ‘footnote' of the Government, while the ability to deliver NHS chief executive Sir David Nicholson's challenge of finding £20 billion of savings in the NHS would be truly 'politically significant'.

He said: 'There is no way we can deliver high quality care to patients unless the scale and nature of the Nicholson challenge is recognised and addressed. I agree with the BMA that this cannot be achieved through salami-slicing of the kind we have seen - it needs to be a system wide reform of healthcare.'

‘I don't think that the NHS bill either in its original form or its current form makes much difference. What is needed is a way to find the political and managerial will to radically change the way service is delivered. We need more integrated services, challenging inadequate clinical practice, intervening earlier in order to deliver care that isn't picking up the pieces in an accident and emergency service and takes more seriously the obligation to improve health and lifestyle.'

He added: ‘The need to adapt the management structure is necessary but it is not the main game in town. It needs to support the core objective of delivering the Nicholson challenge. We must focus relentlessly on that because when the history of this government is written, the Health and Social Care Bill will be a footnote but what will be remembered is that either they delivered this hugely new efficient way of delivering healthcare, which has never been done in the history of this or any other country, or it didn't, in which case the consequences would be politically significant.'

The former health secretary's forthright assessment came as RCGP chair Dr Clare Gerada and BMA chair Dr Hamish Meldrum outlined similar concerns while giving evidence to the health bill committee yesterday.

Dr Gerada stressed that the proposed legislation was distracting from the biggest issues facing the service.

‘Where we will make phenomenal changes is with provider reform,' she said. 'Where doctors get really excited is when we start talking about delivering key services together through an innovative joining together providing real integrated care and removing perverse incentives.'

‘Hospitals are designed to make money by treating patients whilst GPs are meant to reduce patients going into hospital, so you have two systems working against each other. Somehow in the second decade of the 21st century we have to make sure that we tackle those issues through provider reforms, with sensible commissioning enabling us to do that.'

Dr Meldrum told the committee that he believed the legislation was missing the opportunity to drive integration that might provide savings.

The warnings came as the think-tank Reform produced a report suggesting that the NHS would be unable to remain free at the point of delivery without significant changes, because of the rapidly ageing population creating sharply rising demand.