Intended for healthcare professionals


NHS reforms are obstructing the push for efficiency gains, say MPs

BMJ 2012; 344 doi: (Published 24 January 2012) Cite this as: BMJ 2012;344:e579
  1. Denis Campbell
  1. 1London

An influential committee of MPs this week claimed that the government’s radical restructuring of the NHS in England was obstructing the service’s quest to save £20bn (€24bn; $31bn).

A report from the House of Commons Health Committee, chaired by the former Conservative health secretary Stephen Dorrell, said, “The reorganisation process continues to complicate the push for efficiency gains. Although it may have facilitated savings in some cases, we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings.”

The MPs’ findings echo concerns raised previously by bodies such as the NHS Confederation and the healthcare think tank the King’s Fund—and shared by the NHS chief executive, David Nicholson—that it was unrealistic to expect the service to achieve 4% annual efficiency gains every year until 2015 in the midst of organisational upheaval.

The report, on NHS expenditure, also casts doubt on the health department’s confidence that billions of pounds are already being saved by hospitals and primary care trusts as they seek to find their share of the £20bn required by the “Nicholson challenge.” The MPs noted a “marked disconnect between the concerns expressed by those responsible for delivering services and the relative optimism of the government.”

Mr Dorrell, speaking on BBC Radio 4’s Today programme on 24 January, said that the inquiry had found evidence that some places were taking measures to try to control the financial situation that could fairly be described as “short term expedients” or “salami slicing.”

He said, “There are too many examples of areas where …

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