13 Jun 2011

NHS reform plan needs ‘substantial change’

Health and Social Care Editor

Experts advising the Government suggest the NHS reform bill needs some surgery, after hearing of deep-seated concerns over the changes from NHS staff, patients and the public.

The NHS Future Forum, set up to make recommendations on changes the health service reforms, said today there had been serious concerns voiced by staff, patients and the public.

For two months, the forum has spoken to thousands of interested parties and tens of thousands have emailed or posted their views in a “listening exercise” set up by the Government in the face of widespread criticism of its plans for NHS reform.

Their key recommendations include:

• Slowing the pace of change so reforms come in only when and where the NHS is ready.

• Keeping the Health Secretary ultimately accountable for the NHS. The plan had been to devolve power and responsibility to an independent NHS Board.

• Nurses, specialists and other clinicians should be involved in deciding which health care to buy, not just GPs as was originally proposed.

• Competition should be used to improve quality of care not to just drive down prices.

• The role of the regulator Monitor should not be to “promote” competition but to “support choice, collaboration and integration” – that is making sure all parts of the NHS work together to improve care for the patient.

• All parts of the NHS should be subject to more accountability and public openness.

Click on the image for more on the NHS reforms in this Channel 4 News Special Report

‘Important day for the NHS’

Professor Steve Field, who chaired the forum, said he believed the recommendations represented the best balance between meeting public expectation and recognising the enormous financial strain public finances are under.

He said: “This is an important day for us and, we believe, an important day for the NHS.

“We believe our report will, if implemented by the Government, make a very important step forward for the NHS so we can move forward from the current state where it feels to us – as we’ve been out there around the country – that there’s been paralysis there and a lot of fear and concerns.

“Change has to happen and resistance is futile, as they say, because we have to take that forward.”

The Government will respond to the recommendations on Tuesday.

Professor Field, a former chair of the Royal College of GPs, added: “We don’t believe this is an issue that should be a political football.

“We urge politicians to work together to take the NHS forward for the good of patients and if they can that will be a victory for patients, public and staff…this is a golden opportunity for the NHS.”

Financial pressure, not reform, could be the big challenge for the NHS
Professor Kieran Walshe, health policy expert at Manchester Business School, told Channel 4 News the forum had "pushed the boat out" and in some respects suggested significant changes to elements of the bill, particularly regarding competition - if the Government accepts the recommendations.

But he said that financial pressures could turn out to be the biggest challenge for the NHS, rather than implementing the reforms in whatever shape they end up.

He said: "Whatever they do, the next two to three years will be extremely painful, more for financial reasons than anything else. We may look back and think that the future forum and policy changes were not the main issue here but rather the financial strain of £20bn savings."