Groups of GPs working as consortiums only have limited requirements for how they should be made up and held accountable to the public, leaving them with weak governance arrangements.
This is despite the fact they will be responsible for around £60bn of taxpayers’ cash, said the report from the King’s Fund think tank.
It said while the reforms are likely to meet the Government’s aim of reducing centralised control, they will fail to deliver on its commitment to improve local accountability.
The NHS plans have come in for widespread criticism and are on hold while the Government concludes its “listening exercise”. Last week the British Medical Association called for them to be overhauled or scrapped.
Health Secretary Andrew Lansley has said, however, the findings from the listening events do not “suggest that people are wanting to ditch the principles of the Bill”.
Following speculation over the weekend, Number 10 issued a statement insisting Mr Lansley would not be forced to quit over the plans. But his ideas appear to clash with those of Deputy Prime Minister Nick Clegg, who has said changes to the legislation will be so substantial that the Health and Social Care Bill is likely to go back to MPs to be considered for a second time.
The director of policy at The King’s Fund and one of the authors of today’s study, Anna Dixon, said: ‘This report highlights weaknesses in the accountability arrangements set out in the Health and Social Care Bill.
“The pause in the legislative process provides an opportunity to look again at these issues and strengthen accountability in the health system to drive improvements in performance and ensure that public money is well spent.”
The King’s Fund analysis shows that new health and wellbeing boards – designed to link local authorities and communities with consortiums – have very limited powers to hold GP consortia to account.
It says the new NHS Commissioning Board will end up intervening in the work of consortiums to drive performance, undermining the Government’s aim of cutting top-down management of the NHS.
Scaling back the regulator Monitor’s oversight of foundation trusts could also leave accountability in the hospital sector significantly weakened, it adds.
The think tank recommends several measures and warns it may be more difficult for Parliament to hold different parts of the NHS to account in future.
Ironically, this could lead to pressure for a return to greater political intervention in the future, it said.
Yesterday members of the 38 Degrees campaign group used a stretcher to deliver a 400,000-signature Save the NHS petition to the Department of Health, in Westminster.
Members of the lobby group, which launched in 2009, had previously raised £90,000 for full page Save the NHS adverts which were carried in national newspapers to highlight its campaign on the reforms.