Coalition NHS reforms ‘damaging and distracting’, says King’s Fund

Politicians should be wary of again embarking on such a sweeping reorganisation, says report

A new assessment by the King’s Fund finds that the government’s record on NHS reform has been ‘damaging and distracting’.

It finds that leadership has been fractured between several national bodies, resulting in a ‘bewilderingly complex regulatory system’, and that the costly restructuring has created a system that is ‘unwieldy’ and overly complicated.

The King’s Fund says that the period since the Health and Social Care Act was introduced has been characterised by ministerial interference, despite professed intentions to devolve decision making. NHS England has been slow to establish itself, increasingly finding itself hampered by wide-ranging responsibilities.

The new report also says that, while claims of widespread privatisation have been exaggerated, the continued emphasis on competition has led to an increasingly complex situation, with uncertainty as to when contracts should be put out to tender.

Some positive developments are highlighted in the report, including the closer involvement of GPs in commissioning services, more public health responsibility for local authorities and the establishment of health and wellbeing boards where key leaders work together to improve services for the local population. It says that the Care Act 2014 has been ‘an important step towards a fairer system for funding social care’.

But the report criticises the government’s decision to focus on organisational changes at a time when it should have been trying to tackle growing pressures on NHS services and an unprecedented budget squeeze.

Chris Ham, chief executive of The King’s Fund, said:

“Historians will not be kind in their assessment of the coalition government’s record on NHS reform. The first three years were wasted on major organisational changes when the NHS should have been concentrating on growing financial and service pressures – this was a strategic error.

“Only latterly has the government adopted a more positive focus on improving patient care and achieving closer integration of services. Politicians should be wary of ever again embarking on such a sweeping and complicated reorganisation of the NHS.”

The report argues that the next government place less emphasis on inspection and concentrate on providing support for struggling staff.  It also recommends accelerating plans for closer integration of NHS services.

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