REPORT CRITICAL OF NHS REFORM

A NEW report argues that while the Government’s commitment to NHS reform is right, it is in denial about its progress on the ground. The report, published by the independent think tank Reform, states that reform is the only way to unlock the value of the NHS budget but the Government’s programmes remain embryonic, and in some cases in full retreat.
NHS reform: national mantra, not local reality, uses recent academic studies to show that the performance of the NHS across the lifespan is well behind other countries – there is a ´cradle-to-grave gap´. The consultation document for the redesign of the London NHS gave the following assessment: “The UK is falling behind other countries in the quality of care we give to patients, access to care, and the cleanliness of our hospitals.” Improving patient care will need new investment in many areas, but taxpayer funding is (and should be, the report states) restricted in coming years. The key lies in greater productivity.
Two scenarios are depicted. A negative scenario – ´managing NHS decline´ – in which the service delivers substandard quality and access for 11-12 per cent of GDP (c.£110bn – c.£120bn). An outflow of talented staff would increase difficulties.
In the positive scenario – ´NHS opportunity´ – reform delivers immediate access to excellent quality services at a cost of 9-10 per cent of GDP (c.£90bn – c.£100bn).
Current trends point to the scenario of decline. But this is not inevitable, says Nick Bosanquet, professor of health policy at Imperial College London and a consultant director of Reform, said: “The department of health’s strategic challenge is to transform the quality of NHS care within a foreseeable future of tightly limited resources. The NHS does not need a ‘charter’ which amounts to a statement of good intentions. It needs an economic constitution which gives every level of the service the duty to achieve value for money.” If such a constitution, which guarantees patient choice and a diversity of providers, were to be the key conclusion of the department’s current landmark NHS review, it would deliver significant improvement within 18 months, according to the report.