Another contribution to the fierce debate on the reform of NHS England is published in today’s Guardian from WIHSC Emeritus Professor, Morton Warner.

Andrew Lansley cut a lonely figure as he announced a “natural break” to review his NHS reforms. (Guardian 5th April 2011). I would suggest that he and the Prime Minister use the time to subject the existing proposals to two stress tests: if this is right for the banks, surely it must be so to ensure the new NHS will be also be able to meet  future demands. The public expect nothing less for an institution they love and depend upon.

First, the reforms themselves which, it is claimed, will reduce overall costs whilst maintaining quality. Can the data be provided that have been used to make this assertion? And will competition assist or detract?

Second, the central proposal that GPs in consortia can manage (not just spend) 60% of the NHS`s £103bn budget. Here the stress test would need to set the current resource base of suitably trained GPs against the need to manage large budgets and complex commissioning decisions, including the implications of closing existing facilities and health programmes – both inevitable in economic terms and as care technologies change.

To prejudge the reaction to my suggestion, I can only imagine the Prime Minister and Andrew Lansley would not find clarity to be necessarily helpful nor would they even be willing to embark on the stress tests in the first place. In the absence of such action a bonfire of the vanities is the only solution. The reforms wrongly provide a temptation to sin; and the risk of getting caught is great. Let the proposed NHS National Future Forum proceed without bias!

Written by Morton Warner, Emeritus Professor

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