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The government's NHS White paper “Liberating the NHS” outlines one of the most radical reorganisations in its 60 year history at an estimated cost of £2-3bn.  But have we been here before? 

Kieran Walshe, Professor of Health Policy and Management at Manchester Business School says that “there is very little evidence that past NHS reorganisations have produced improvement” and argues the new government "looks likely to make all these mistakes again." In an editorial published on bmj.com today,  Professor Walshe explains that few of these reorganisations have been properly evaluated and a recent National Audit Office study of over 90 government reorganisations found that, despite huge costs, the benefits were unclear, the process was often poorly managed, and that its impact on performance was often adverse.  Those working in the NHS will recognise this situation; as often the restrucutures have been politically motivated rather than for organisational performance improvement.

He goes on to say that reorganisation can "adversely affect" service performance and be a "huge distraction from the real mission of the NHS" - delivering healthcare and improving healthcare quality. Walshe also argues the reorganisation risks absorbing a "massive amount" of managerial and clinical time and effort.  The only fundamental changes outlined in the white paper are not clinically linked but designed to shift power to independent contractors (GPs)to make purchasing decisions from NHS service providers (independent foundation trusts, social enterprises and private sector companies), in other words, privatisation of the NHS.

 
Have previous privatisations improved services from water or energy providers?  We know that we have choice as consumers but are services better?  Is there evidence to show water companies are more successful and reducing waste?

Walshe urges the government to produce evidence to justify the case for change. "The intended costs and benefits must be made explicit and measurable...and a systematic analysis of the impact of the reorganisation should be produced within two years of its implementation and presented to parliament."    26/07/10  Wendy Garcarz

Last Updated on Tuesday, 27 July 2010 08:26