MPs fear 'disruptive' plans for NHS put £20bn savings at risk

The Health Select Committee says the savings programme is already a "high-risk strategy" but the plans to hand over 80bn in public spending to family doctors by 2013 "increased the level of risk considerably without setting out a credible plan for mitigating that risk".

MPs said "unprecedented" efficiency gains were required and the best way to do that was through improving arrangements over how money was spent but Ministers had failed to show their plans were the most efficient way of delivering good patient care.

They also said they were "surprised" by the significant policy shift between what the coalition promised to do in May and the plans it set out for the health service in July in a "disruptive reorganisation of the institutional structure of the NHS which was subject to little prior discussion".

"The committee does not believe that this change of policy has yet been sufficiently explained given the costs and uncertainties generated by the process," said the report.

MPs said the priority for the NHS was to find 20bn in efficiency savings.

This was already "extremely challenging" and the failure to properly plan for upheaval in the NHS was of "particular concern" in the current financial climate. And the committee's report called for detailed clarification on how the arrangements would work in practice amid concerns Ministers had failed to set them out.

Laurence Buckman, chairman of the British Medical Association's GPs' committee, said the approach had the potential to improve both the efficiency of the health service and patient care.

"However, we too are very concerned about the scale and pace of these reforms, coming as they do when the NHS also has to find up to 20bn in efficiency savings," he said.

"The speed of the reforms means primary care trusts are imploding as staff leave in droves and those managers who are left are focused on delivering the reforms rather than efficiency savings and the maintenance of patient care."

The report comes ahead of tomorrow's publication of the Health and Social Care Bill which details the radical overhaul.

Most of the NHS budget will pass to GPs, who will take control of commissioning services for patients.

Regional health authorities and primary care trusts (PCTs) – which currently commission services – will be abolished.

Ministers yesterday unveiled the latest "pathfinder consortia" who will test the commissioning plans.

Seventeen have now been approved in Yorkshire amid signs there will be around double the existing number of 14 PCTs.

Arrangements vary significantly with some covering the same area as PCTs including 330,000 patients in the East Riding but another in South Elmsall near Pontefract covers just 21,000 patients.

Four will be created in Sheffield and three in Bradford.

The huge differences are likely to fuel fears that management expertise could be spread too thinly and costs of bureaucracy could also be driven up. A similar model was abandoned by the NHS only five years ago as part of efforts to save money.

Health Secretary Andrew Lansley said the NHS must simplify its structure and cut bureaucracy to release further savings for patient care.

"If we want better results for patients and a more efficient NHS, then we must devolve power to general practices," he said.