‘Disruption’ of NHS reforms accused of damaging services

In a highly critical report, the health select committee said hospitals were resorting to short-term “salami slicing” to make savings instead of focusing on long-term measures including redesigning how services are provided under a drive to deliver £20bn in efficiency savings by 2015.

But in stinging criticism of Health Secretary Andrew Lansley’s reorganisation, it said the process “continues to complicate the push for efficiency gains”.

The attack comes despite a coalition majority on the committee and only days after doctors, nurses and midwives announced outright opposition to the landmark Health and Social Care Bill.

The committee found “disturbing evidence” that cost-cutting measures being implemented “could fairly be described as ‘short-term expedients’ or ‘salami slicing’” and the size of the challenge had not been fully grasped.

NHS bodies were “making do and squeezing existing services” in the first year of the savings programme rather than looking for long-term reforms to achieve their objectives, it found.

They raised serious doubts over Department of Health claims that only a fifth of the £20bn savings that were required needed to be generated from reforms, warning that genuine change in the way services were delivered would be necessary.

MPs concluded that it was “far from certain whether the targets... will be met, even with trusts stretching themselves” and the task was being made harder by the shake-up of the entire NHS structure at the same time.

“Although it may have facilitated savings in some cases, we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings,” they concluded.

Committee chairman former Health Secretary Stephen Dorrell played down the significance of the impact of the Government’s reforms, insisting the NHS was “well used to management change”.

He said: “The NHS funding challenge can only be met by rethinking and redesigning the way health services are delivered now, in order to deliver lasting long-term benefits.”

Royal College of Nursing chief executive Peter Carter said: “We feel that the dual impact of the reform process and the full extent of the efficiency savings is now seriously destabilising the NHS. Indeed, in our opinion the Bill has created such turmoil that it should be stopped.”

NHS Confederation chief executive Mike Farrar said: “This report starkly highlights the weight of financial pressure that is bearing down on the NHS. Anybody who thought the NHS was simply ‘protected’ is sleep walking into some serious difficulties.

“We don’t want to see local NHS leaders making unplanned cuts in response to crises caused by problems that have festered. We need politicians to face the issues and to take the decisions that will allow people to plan properly.

“If we are to keep the NHS sustainable in the long term, we need to fundamentally reorganise the way we deliver care in the best interest of patients.”

Mr Lansley claimed £7bn in efficiencies had been made in the last 18 months. “Our plans for modernisation are essential if we are to put the NHS on a sustainable footing for the future,” he said.

“Only when we give nurses and doctors more power will we see local NHS services reshaped to suit patients so they can see who they want where they want.”