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Fears over health reform 'risks'

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NHS organisations have warned of “significant risks” that the government’s restructuring of the health service will leave GP consortia poorly equipped to take on their new commissioning role because of a loss of professional expertise.

NHS organisations have warned of “significant risks” that the government’s restructuring of the health service will leave GP consortia poorly equipped to take on their new commissioning role because of a loss of professional expertise.

The concern is one of many raised in the NHS Confederation’s response to the white paper Equity and excellence: Liberating the NHS.

The charity, which represents 95% of NHS organisations, said it was concerned that the transition period during which primary care trusts will be scrapped and replaced by GP commissioning consortia posed the biggest problems.

It said the level of culture-change and the potential loss of skills from PCTs was a particular concern with staff being too used to top-down structures.

Meanwhile, it questioned whether the necessary transformation could be carried out against a backdrop of 45% cuts to management costs estimated at some £20bn.

NHS Confederation acting chief executive Nigel Edwards, left, said that while the reforms were a move in the right direction, they required a major shift in culture and the way the NHS did business, as well as a shakeup of institutions.

“It is imperative that the government does everything possible to address what is a significant list of uncertainties about how the new system will work,” he said.

“The fact of the matter is that the government is planning to build a very big new machine - at great pace - but no one can be quite sure what will happen when it is switched on.

“Ministers also need to ease the very deep worries that people feel about the transition.

“This is the area where people’s concerns have been greatest because there is a real danger of failures in quality of care or finances. We are about to embark on a hazardous journey at a time when resources are hugely stretched.

“The risks are very real indeed.”

Among the support requested from the government is the creation “as a matter of urgency” the creation of an “effective human resources network” to keep the necessary level of professional knowledge available to GP consortia.

The submission also calls for:

  • A review of Department of Health management burdens placed on strategic health authorities and PCTs aimed at scrapping those that do not add value to local health economies;
  • Mechanisms for upper-tier authorities to hold lower-tier councils to account for the delivery of public-health goals;
  • Consideration for the idea of giving Citizens Advice Bureaux a formal role in dealing with health complaints, rather than building a parallel system through local HealthWatch organisations.

The Equity and Excellence: Liberating the NHS white paper

NHS Confederation white paper consultation response

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