Too far, too fast: King’s Fund urges caution on health reforms

The King’s Fund has called on ministers to reconsider the speed and scale of new health reforms warning of “significant risks” at a time of increasing financial pressures for the NHS.

In its response to the government’s health White Paper the think-tank said the case for radical reorganisation had not been made to justify these measures.

Therefore it said reforms should be rolled out more slowly if ministers are to deliver lasting benefits to patients and improve NHS performance.

These criticisms add to attacks on the speed and scale of the reforms and worries about damage to the current integration process, which have come from organisations such as the British Medical Association, the Royal College of GPs and the Local Government Group.

They also serve to increase the pressure on health secretary Andrew Lansley who continues to insist he will stick to the timetable.

The King’s Fund said it supported the need for reform and many of the government’s proposals.

These include giving GPs a stronger role in commissioning services, extending choice for patients and enhancing the role of local authorities in the public health system.

However, it questioned the need to embark on a fundamental reorganisation of the NHS when health outcomes and public satisfaction have improved in recent years.

The King’s Fund said the scale and speed of the reforms will distract attention from finding the efficiency savings needed to maintain quality and avoid cutting services.

Instead it argued that rather than rushing out the reforms ministers should consider working with GPs who are ready to embrace GP commissioning and using their experience to inform the national roll-out, rather than imposing the GP consortia model in all areas of the country by 2013.

Rather than scrapping primary care trusts and strategic health authorities by 2013, it said that NHS structures should be streamlined. Furthermore the system should be designed to encourage increased collaboration alongside competition.

Professor Chris Ham, chief executive of The King’s Fund said: “I hope ministers will think again about the plans for implementing these proposals.

“This does not mean putting the brakes on across the board. In some areas, they could in fact move more quickly by beginning to test out and evaluate how key elements of the reforms will work in practice.”

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