Cameron’s NHS reorganisation likely to widen the health funding gap

Andrew Georgiou gives a critical analysis of David Cameron's recent speech on the planned NHS reforms, pointing out that it ignored a key factor, competition.

David Cameron, in a speech at Ealing Hospital yesterday, affirmed his support for Andrew Lansley’s controversial NHS shake up.

In an attempt to shore up support for his government’s ailing NHS reforms David Cameron’s speech sought to explain why change is important for the future of the NHS. What followed, however, were not the words of a man who had taken “time to pause, listen and reflect”. Instead Mr Cameron’s speech neglected to tell the whole story and was almost devoid of any mention of the key issue, competition.

The key plank of Mr Cameron’s address was that his changes were needed in order to save money in the future. He said:

“If we stay as we are, the NHS will need £130 billion a year by 2015 – meaning a potential funding gap of £20bn. The question is, what are we going to do about that.”

He may be asking the right question but he is far from providing the right answer. The truth is that Mr. Cameron’s perilous NHS reforms are going to divert much needed attention away from the key challenge of finding the £15-20bn savings it has been asked for. The King’s Fund rightly points out that:

“Finding the £20 billion in efficiency savings needed to maintain services must be the overriding priority, so the very real risk that the speed and scale of the reforms could destabilise the NHS and undermine care must be actively managed.”

The prime minister may believe that the solution to these funding problems lays in his reform, however the Department of Health disagree. They assert that the funding challenges will “present a significant challenge to the NHS regardless of the structure of the health system”.

So rather than helping to close the £20bn funding gap the government’s misadventure with NHS reform will most likely widen it.

The prime minister also claims that his reforms will see the end of postcode lotteries. However his vision of “an NHS with consistent, high quality care for all – instead of just pockets of excellence” will not be fulfilled under these proposals.

It was just two months ago that the NHS Confederation stated that the government’s plans would worsen the postcode lottery and will mean more variability of access to services. Is the prime minister really saying that he knows more about the NHS than the professionals?

In fact most of Mr Cameron’s harshest critics have been healthcare professionals themselves and Clare Gerada (Chair of the Royal College of General Practitioners), who represents 42,000, GPs believes “that if this Bill is enacted as it currently is that it will cause irreparable damage to the core values of the NHS”.

Mr Cameron’s speech may have been a little sloppy on the detail but it was his silence on the most important part of these reforms that was worrying. David Cameron clocked up twelve pages and almost 4,000 words but only mentioned the issue of competition once. If he intends to ram these reforms through parliament it is this issue that needs addressing the most.

This speech was another demonstration that the government are intent on ignoring all professional evidence and continuing to press ahead unabated. Someone needs to tell the prime minister if he wasn’t talking so much it would be easier to hear what people are saying.

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