Government has mandate for NHS reform, says Dorrell

pharmafile | July 8, 2010 | News story | |  NHS, government 

In return for ringfencing the NHS’s budget, the government now has a strong mandate for reforming health services, says the new chairman of the House of Commons health select committee.

Stephen Dorrell, who was health secretary under the previous Conservative government in the 1990s, insists change is the quid pro quo for protecting the NHS from cuts.

“Because we have made that commitment we now have a licence to undertake reform of the system, to ensure the money is being used for that,” he told Public Finance magazine.

“There is a danger that ringfencing the NHS budget gives the NHS a ‘get out of jail free’ card, which it does not,” he added.

Last week the coalition made its first moves to change the way health services operate by piloting direct payments to patients to allow them to choose how their treatment is delivered.

Aimed at areas such as diabetes, stroke, heart disease, end of life care and mental health conditions, it is a philosophical pointer for the new government in favour of choice and against PCTs imposing services for patients.

But Dorrell’s words are slightly at odds with a new report from the 2020 Public Services Trust (2020PST), which suggests ringfencing is not the way to go and questions “the economic sustainability of even a protected health service budget”.

Dorrell is on 2020PST’s health working group, along with others including NHS Direct chair Joanne Shaw and Jennifer Dixon, director of the Nuffield Trust.

A poll by the thinktank earlier this year found that 82% of people thought the NHS should be prioritised for protection from cuts.

The thinktank observes that the NHS “apparently is electorally sacrosanct”, but warns that ruling out spending cuts in the NHS will mean much deeper cuts in other areas of public services.

The UK’s ageing population will cost an extra £300 billion by 2025, according to one estimate, and 2020PST argues that meeting these challenges over the long term “will require more than squeezing efficiencies from the current health and social care system, and more than simple ringfencing of existing departmental budgets”.

Policymakers will have to combine “an efficiency squeeze with creative ways of meeting citizens’ needs differently”, it says.

Adam Hill

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