Senior Tories admit NHS reorganisation was worst mistake since being in government

BMJ 2014; 349 doi: (Published 14 October 2014) Cite this as: BMJ 2014;349:g6221
  1. Gareth Iacobucci
  1. 1The BMJ

Senior Conservative politicians have admitted that their controversial reorganisation of the NHS in England was the worst mistake they have made since being in government, the Times newspaper has reported.

The report claims that Prime Minister David Cameron and Chancellor George Osborne regretted their failure to understand the scale and effects of the plans devised by the former health secretary Andrew Lansley, described by one insider as “unintelligible gobbledygook.”1

It said that Downing Street officials now regarded the changes as a “huge strategic error,” with a former adviser to Number 10 quoted as saying, “No one apart from Lansley had a clue what he was really embarking on, certainly not the prime minister. He kept saying his grand plans had the backing of the medical establishment, and we trusted him. In retrospect, it was a mistake.”

The full scale structural reorganisation of the NHS was enacted in the Health and Social Care Act 2012, despite opposition from the medical profession and beyond. The implementation of the changes, which included the abolition and redeployment of several tiers of NHS management, is estimated to have cost more than £1.5bn (€1.9bn; $2.4bn).2 The plans were so contentious that the government announced an unprecedented “pause” in the legislative process to allow further consultation.3 It eventually pushed through a modified version of the bill after dissent from the Liberal Democrats was quelled.4

The Times quoted a senior Cabinet minister as saying, “We’ve made three mistakes that I regret, the first being restructuring the NHS. The rest are minor.”

It also quoted an ally of Osborne, who disclosed that the chancellor regretted not blocking the legislation before it became law. “George kicks himself for not having spotted it and stopped it. He had the opportunity then and he didn’t take it.”

Senior figures from the medical profession were scathing about the disclosures. Writing on the social media website Twitter, Clare Gerada, former chair of the Royal College of General Practitioners, said that doctors would have been referred to the General Medical Council if they had acted in the same way. “If a doctor implemented untested, unnecessary, harmful [medications] they would be struck off,” she wrote.

Clive Peedell, a consultant oncologist and co-leader of the National Health Action Party, which was set up in opposition to the reorganisation, said that the admission was “a huge embarrassment for the Tories but also a depressing revelation.” He said, “It’s no surprise to us that these reforms have been a disaster as this is exactly what we predicted: a huge mistake from start to finish.

“This damaging reorganisation has wasted billions of pounds at a time of unprecedented NHS austerity, has accelerated privatisation, worsened patient care, and left the NHS facing a £30bn funding gap by 2020.”

Andy Burnham, Labour’s shadow health secretary, said, “David Cameron’s reorganisation inflicted chaos on the NHS and has dragged it down. Patients, doctors, and nurses pleaded with the government to stop it—knowing it would cause chaos—but they refused to listen back then, and an apology now is no use.”

But the current health secretary, Jeremy Hunt, defended the changes, insisting, “Andrew’s structural changes are saving the NHS more than £1bn a year. The difficult question for those who complain about Andrew’s reforms is: where would we have found the money otherwise?”


Cite this as: BMJ 2014;349:g6221


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