09 July 2004
The Conservatives' plans to cut £1.7bn from NHS bureaucracy would be difficult to achieve, the NHS Confederation said this week.
The managers' organisation was responding to the interim findings of a Conservative party committee, headed by business expert David James, that is examining ways of cutting waste in the public sector.
The Tories said James had identified £1.7bn in savings that would be ploughed into frontline services. Much of the cash would be saved by abolishing or reforming institutions established under the Blair administration.
These included removing the commissioning function of primary care trusts in relation to elective surgery and all subsequent planned care. PCTs would be merged. The 28 strategic health authorities in England would be scrapped and their residual functions assumed by the enlarged PCTs. National targets – on waiting times for example – would be abolished.
James would also follow the government's policy of slashing the Department of Health bureaucracy, and abolishing, merging, outsourcing and reducing the role of NHS quangos. However, it is not clear whether the Conservatives would go further than the plans already laid down by the government, which includes halving the number of arm's-length bodies to 21 to save £500m.
NHS Confederation chief executive Gill Morgan said it was difficult to see how some of the proposed savings would be achieved, particularly the changes to commissioning.
'There is a set of tasks that can't just be stopped – from managing budgets and planning services to providing information. This will still require resources, whether tasks are carried out by PCTs or GPs,' she said.
Restructuring the NHS was not the answer. 'The political parties' efforts to outbid each other with claims to cut NHS bureaucracy is both damaging and unimaginative,' she added.
'This bureaucracy bidding war also serves to perpetuate the myth that the NHS is over-managed, when in reality only 4p in every pound is spent on management costs, and independent bodies like the Audit Commission have said that management capacity in the NHS is thinly spread.'
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