Intended for healthcare professionals

Observations NHS White Paper

Why the plans to reform the NHS may never be implemented

BMJ 2010; 341 doi: (Published 14 September 2010) Cite this as: BMJ 2010;341:c5032
  1. Chris Ham, chief executive, King’s Fund, London
  1. C.Ham{at}

    Medical politics and party politics could yet frustrate the enactment of the government’s proposals

    Irrespective of the outcome of Unison’s request for a judicial review of the coalition government’s plans to reform the NHS in England (BMJ 2010;341:c4716, doi:10.1136/bmj.c4716), ministers will have to fight on several fronts to implement the white paper Equity and Excellence: Liberating the NHS. Major challenges include completing the design of the reforms, winning the support of those they are seeking to liberate, and holding the coalition together to secure implementation.

    The white paper and the accompanying consultation documents set out the government’s plans in broad outline and lack the detail needed to give confidence that they will deliver the improvements in care that have been promised. Much more thought must be given to managing the transition from the current system to the one proposed and to how commissioners, providers, and regulators will relate to each other in future.

    Critically important will be ensuring that general practitioners are ready to take on their new responsibilities as arrangements are made to abolish …

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