NHS reforms ‘will lead to confusion’

The former Labour health secretary, now a government adviser on social mobility, joins criticism of Andrew Lansley • Alan Milburn: Labour will contest, not concede, NHS reform A former health secretary, Alan Milburn, has attacked the government’s health reforms, describing them as confused, liable to increase bureaucracy and expected to shift power sideways rather than down to patients. His criticism in a Guardian article is significant since the health secretary, Andrew Lansley, and David Cameron frequently cite Blairite public sector reformers such as Milburn in defence of their health moves. Milburn was asked this month by the government whether he would apply for the post of chairman of the NHS commissioning board, the new arms-length body that is due to run the NHS after the reforms. He is already the government’s adviser on social mobility. His article, presaging further criticism in the magazine Progress, will be another blow to Lansley as he continues to resist criticisms of his reforms from an ever-widening alliance of health professionals, Liberal Democrats, unions and public opinion. The Lib Dems, at their conference, and the BMA voted to reject Lansley’s reforms. Nick Clegg has said he will require major revisions before the bill introducing the reforms currently in committee can return to the Commons for its report stage. Milburn also warns Labour that it must not make the mistake of being opposed to any reform of the NHS. It is expected that Ed Miliband and the shadow health secretary, John Healey, will set out Labour’s position in greater detail in the next fortnight. They will argue that the central ethos of public service reform must be co-operation and not competition between providers, as proposed. The Lansley reforms abolish primary care trusts and hand commissioning of a potential £80bn NHS budget to local GP commissioning boards capable of handing contracts to any willing provider. The reforms will also allow all NHS foundation trusts to become fully independent by 2014, and in the process abolishes many NHS targets set by the government. Milburn writes: “It’s a bad idea to let hospitals off the accountability hook by abolishing the national targets that drove better lower waiting times during the last decade. Cutting waste is a good idea but it’s a bad idea to assume that NHS structural change saves cash rather than costing it. Abolishing PCTs and creating more GP consortia to replace them hardly sounds like a recipe for reducing bureaucracy. “There’s also a chasm between the cost of making change – £1.4bn – and the cash available for it. The NHS budget will fall not rise in the next few years so it is relying on £20bn efficiency savings to make ends meet. Structural change can only distract it from doing so.” Milburn is one of many critics who believe the government will end up making PCT managers redundant and then rehiring them to run GP commissioning boards. The government has tried to reduce this risk by banning anyone working for a PCT being re-employed for a GP board within six weeks. Milburn praises the idea of family doctors facing the consequences of their own prescribing and treatment, but writes: “It’s a bad idea to weaken public accountability over £80bn of public money and to assume that GPs can easily do the complex business of commissioning local services.” Milburn believes the government will have to reintroduce the Lib Dem concept of greater local accountability, the original proposal put forward by the Lib Dems in their manifesto but then weakened in coalition negotiations. But Milburn also urges Labour to box clever in its opposition to the NHS reforms, saying competition can improve the NHS. He writes: “In local areas where new providers were brought in to provide NHS services, waiting times and death rates fell faster than where they weren’t. Labour should promote a legal, level playing field based solely on the interests of patients, not providers. But that requires proper planning, not a free-for-all. Market mechanisms can work in healthcare but only when properly managed and regulated.” Milburn also admits to being unable to understand the politics behind the government’s NHS reforms, arguing Cameron had always seen safety first on the NHS as critical to decontaminating the Conservative brand. In a series of clarifications, Lansley has already promised not to allow competition based simply on price, and said that commissioning consortia would not hold on to, or share with private companies, savings from commissioning budget. In a change of language he has said “any qualified providers” will be entitled to provide NHS services. He had previously promised “any willing provider” would be entitled to provide the services. NHS Health Andrew Lansley Patrick Wintour guardian.co.uk

Posted by on March 28, 2011. Filed under News, Politics, World News. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.