Doctors attack 'risky' strategy for reform of health service

Health Secretary Andrew Lansley's decision to go ahead with the abolition of Primary Care Trusts (PCTs) and give GPs control of much of the NHS budget has been met with concern by patients and unions who warned it was "very risky".

And last night the Government faced claims it was "masking" a funding shortfall for hospitals as the health service is forced to find up to 20bn in efficiency savings by 2015, while Labour accused the coalition of breaking promises over health funding.

The Government said 89bn will go direct to primary care trusts (PCTs) for front-line services next year, which it insisted was equivalent to a 2.6bn – three per cent – increase in funding. PCTs will have two per cent of their funding held back to pay costs of the changes, such as redundancies.

But the British Medical Association (BMA) said it did not accept the Government's claim, arguing that local services are already being "rationed" amid fears some hospitals will run into financial difficulties.

BMA chairman Dr Hamish Meldrum, a GP in Bridlington, said: "The stated three per cent increase in funding for primary care trusts includes 1bn already announced to cover additional social care responsibilities and masks the fact that hospitals will have to do a lot more work to achieve the same income."

The Government's decision to press ahead with the bulk of reforms in its white paper to reform the NHS also prompted criticism from the BMA and other unions.

PCTs and Strategic Health Authorities will be abolished, with GPs taking control of most of the NHS budget by 2013. In an unexpected move, senior management teams at Yorkshire's PCTs will be forced to merge by next June, with the current 14 management teams likely to be reduced to four or five as the changeover to "GP consortia" begins to take place.

The Government said it had listened to the concerns and made amendments, such as placing commissioning of maternity services with GPs instead of a National Commissioning Board and allowing a "longer and more phased transition period" for some reforms.

However, the response said the Government "disagrees" with campaigners that the scale of the reforms are too big, untested or are occurring at the wrong time.

But Dr Meldrum said: "Change of this magnitude was always going to be a challenge and the worsening financial pressures on the NHS, coupled with the ambitious timescale and lack of detail, make the present strategy very risky.

"The BMA will consider the Government's response in detail but our initial reaction is that they seem committed to charging forward with these changes despite the warnings and despite the risks."

Unite said Health Secretary Andrew Lansley had not listened to fears about the speed of reforms and was intent on driving the NHS into "the buffers".

Katherine Murphy, chief executive of the Patients Association, said the NHS has to find savings of 20bn "at a time when it is also facing the biggest restructure of health services since it was set up in 1948".

She added: "Why are we spending money on massive changes to the NHS when at the same time they are also being asked to make such huge cuts?

"We are deeply concerned that the logistics of implementing these reforms have not been fully considered and that the public are not engaged with the process."

Mr Lansley also pledged to hold hospitals "to account", with fines if they fail to get rid of mixed-sex wards. Hospitals will lose part of the funding for a patient if that patient has to share with the opposite sex, unless they have consented to it. Those failing to comply will be named.

The plans were unveiled as David Cameron clashed angrily with Labour leader Ed Miliband on health funding in the House of Commons. The Government insists health spending will rise by above inflation in each of the next four years, but Mr Miliband claimed that promise was being broken.

A spokesman for NHS Yorkshire and the Humber said: "Our PCTs across the region have a strong record of collaborative working and we will be getting together shortly to discuss how best to take forward the plans set out in the 2011/2012 Operating Framework."