Major shake-up for NHS

Date published: 14 July 2010

The NHS in England is to undertake a major reform in one of the biggest shake-ups in its history to rid the health service of bureaucracy.

Hospitals will be moved out of the NHS to create a "vibrant" industry of social enterprises under the proposals and GPs are to take charge of the budget.

The move will lead to the abolition of all 10 strategic health authorities and the 152 primary care trusts.

Meanwhile, responsibility for public health will be passed to local authorities.

Health Secretary Andrew Lansley said the proposals would be challenging and turn the NHS ‘upside down’ but in doing so help reduce management costs by nearly a half within four years.

The plans mean GPs working in groups will be in charge of a vast collection of hospital, mental health and community services, however, specialist services and dentistry will not fall under their remit.

Mr Lansley believes GPs are better placed than managers to make decisions about their services.

David Furness, author of the Social Market Foundations major health report, said: "Giving control of NHS funds to GPs is like asking your waiter to manage a restaurant. They might know what you want to eat but they won't necessarily be any good at ordering stock, designing a menu or controlling the chef.

“Commissioning healthcare is very difficult and needs a specialised organisation to do it. And the evidence suggests that small commissioners find it difficult to take on powerful providers and reform services. GP commissioning risks handing real control of the NHS to vested interests on the provider side as GPs simply won't have the muscle to drive through change.

Mr Furness added: "And GP consortia will need organisational support to work effectively. Who else could do this but current PCT staff? This new NHS reorganisations will mean wasted years reinventing the system we have now. And with the prospect of a funding squeeze that will certainly have an impact on patients, this is no time to introduce an ideologically driven policy that forces GPs to become NHS managers. Instead the government should be focusing on what it can do to strengthen existing commissioners - PCTs.

"At best this will be a waste of time, at worst a waste of money."