Half-baked NHS reforms could harm patients, says think-tank
Patients could suffer from reforms to introduce choice and competition in the NHS unless the government gives a clearer commitment to establishing a full-blown market for the supply of healthcare, according to a leading think-tank.
In a report published today by the King's Fund, ministers are accused of sending mixed signals about their commitment to establishing a market among healthcare suppliers, "one day implying they are in favour, another denying some of the likely consequences".
The report*, drawn up by a group of senior executives from the NHS, private and voluntary sectors, calls for a clearer split between commissioning and supply, an overhaul of regulation including a new competition body for healthcare, and no arbitrary limit to the role of private or independent providers.
The King's Fund notes how the government has shifted towards a market system, with payment by results, semi-independent foundation hospitals and a bigger role for the private sector.
But it concludes that without an unequivocal commitment to a market among suppliers, patients will not only fail to win the full benefits of competition and innovation but could lose out if the strengths of services such as emergency care are damaged by half-baked reforms.
The report calls for the government to explain to voters and sceptical MPs that the outcome of its reforms is a clearer split between commissioning healthcare and its supply, with local commissioning bodies or family doctors purchasing care for patients from a variety of suppliers.
Ministers should set the budget and overall policy goals, but step back from day-to-day management. "Without clarity on this, there will be muddle. Muddle will be dangerous for patients," the report said.
The report also calls for an overhaul of the regulation of healthcare suppliers with a regime to deal with financial or clinical failure, to allow mergers and acquisitions and maintain competition.
The Department of Health should be split, most probably into three separate bodies: a rump department overseeing the NHS budget and general policy; a separate commissioner of services to buy care for patients; and a separate entity overseeing NHS services, whose role would shrink over time as NHS staff transferred to independent employers.
Ministers have set no formal limit to the slice of healthcare that could be provided by theprivate sector but have said itis unlikely to grow beyond 15per cent in the foreseeable future.
*Designing the 'new' NHS - ideas to make a supplier market in health care work, published by the King's Fund
http://news.ft.com/cms/s/e43471fc-f42f-11da-9dab-0000779e2340.html
What we are now seeing in Labour's brave new world is change for change sake, with no coherent long term answer for funding nor supply.
As the King’s Fund chief executive Niall Dickson said: “The move towards the introduction of a supplier market has been achieved with surprisingly little serious discussion and there is still some uncertainty about where it is all heading. We very much hope this stimulating report will generate debate over what needs to be done to ensure high quality care within a market system.
In a report published today by the King's Fund, ministers are accused of sending mixed signals about their commitment to establishing a market among healthcare suppliers, "one day implying they are in favour, another denying some of the likely consequences".
The report*, drawn up by a group of senior executives from the NHS, private and voluntary sectors, calls for a clearer split between commissioning and supply, an overhaul of regulation including a new competition body for healthcare, and no arbitrary limit to the role of private or independent providers.
The King's Fund notes how the government has shifted towards a market system, with payment by results, semi-independent foundation hospitals and a bigger role for the private sector.
But it concludes that without an unequivocal commitment to a market among suppliers, patients will not only fail to win the full benefits of competition and innovation but could lose out if the strengths of services such as emergency care are damaged by half-baked reforms.
The report calls for the government to explain to voters and sceptical MPs that the outcome of its reforms is a clearer split between commissioning healthcare and its supply, with local commissioning bodies or family doctors purchasing care for patients from a variety of suppliers.
Ministers should set the budget and overall policy goals, but step back from day-to-day management. "Without clarity on this, there will be muddle. Muddle will be dangerous for patients," the report said.
The report also calls for an overhaul of the regulation of healthcare suppliers with a regime to deal with financial or clinical failure, to allow mergers and acquisitions and maintain competition.
The Department of Health should be split, most probably into three separate bodies: a rump department overseeing the NHS budget and general policy; a separate commissioner of services to buy care for patients; and a separate entity overseeing NHS services, whose role would shrink over time as NHS staff transferred to independent employers.
Ministers have set no formal limit to the slice of healthcare that could be provided by theprivate sector but have said itis unlikely to grow beyond 15per cent in the foreseeable future.
*Designing the 'new' NHS - ideas to make a supplier market in health care work, published by the King's Fund
http://news.ft.com/cms/s/e43471fc-f42f-11da-9dab-0000779e2340.html
What we are now seeing in Labour's brave new world is change for change sake, with no coherent long term answer for funding nor supply.
As the King’s Fund chief executive Niall Dickson said: “The move towards the introduction of a supplier market has been achieved with surprisingly little serious discussion and there is still some uncertainty about where it is all heading. We very much hope this stimulating report will generate debate over what needs to be done to ensure high quality care within a market system.
posted by Dr Search- Principal Consultant at the Search Clinic at
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