16 December 2005
The NHS has two years to implement the government's radical market and choice reforms or else risk undermining the 'founding values' of a free service based on need, Health Secretary Patricia Hewitt stated this week.
Delivering a lecture at the London School of Economics, Hewitt argued that the introduction of hospital competition for patients – which starts in earnest in January 2006 – was necessary to 'embed' a new patient-led culture into the NHS.
That cultural change would have to be completed by the end of 2008, said Hewitt – when the current record increases in funding end and future funding 'resumes a more normal course'.
Hewitt said that turning away from the new policies now could spell disaster. 'Having asked people to pay more for the NHS, and having failed to deliver the transformation we promised, we would open the way to those who do not share our values and commitment.
'If we don't make changes, radical changes, others will – but they will do so in ways that wrench it from its founding values,' she warned.
Hewitt also rejected the notion that the level of deficits in the NHS – forecast to reach £650m – were caused by the introduction of the new payment by results funding mechanism, in which funding follows the patient.
She added: 'Because the system is far more open, far more transparent… it is revealing underlying deficits that in the past were often concealed.'
Hewitt said that because PBR forced hospitals to compete for patients and to carry out procedures within the PBR national tariff, it would eventually have the effect of increasing clinical effectiveness and cost-efficiency within the NHS.
But John Appleby, chief economist at the King's Fund, said that it was worrying that the Department of Health did not seem to be clear on what its criteria for success for the next two years would be.
He said that it seemed likely that NHS organisations would focus on addressing their underlying financial problems, even if that meant some cuts in services, which would undermine their ability to offer patients genuine choices.
'It's going to be a bit like the “must do” on waiting list targets. They're going to switch emphasis to “must do” on financial balance, so there'll be intense pressure over the next few years to sort that out,' said Appleby.
PFdec2005
