Andrew Lansley’s ‘damaging reforms at root of the current NHS crisis’

Changes set out in the Health and Social Care Act 2012 amounted to the 'biggest and most far-reaching legislation in the history of the NHS', the King’s Fund said.

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The Coalition’s health reforms were “damaging and distracting” for the NHS, and government policy for the past two years has been “devoted to limiting the damage”, health experts have said.

In a highly critical report, the King’s Fund think-tank said the reforms pushed through by the former Health Secretary Andrew Lansley had probably contributed to the current crises in the NHS.

Changes set out in the Health and Social Care Act 2012 amounted to the “biggest and most far-reaching legislation in the history of the NHS”, the King’s Fund said.

Drawn up during Mr Lansley’s time in opposition from 2005 to 2010, they were outlined in a now-notorious White Paper in 2010, subheaded “Liberating the NHS”. They led to the complete overhaul of the management and bureaucratic structure of the NHS, while also placing a stronger emphasis on competition and markets in the provision of care.

But they coincided with a time of rising pressure on hospitals and GPs from an ageing and growing population, as well as a dramatic slowdown in government funding.

The reforms damaged the NHS at a crucial time, the King’s Fund said. “Arguments about privatisation distract from the much more important and damaging impacts of the reforms on how the NHS is organised and the ability of its leaders to deal with rapidly growing financial and service pressures,” the report states.

“By taking three years to dismantle the old structures and reassemble them into new ones, the Government took scarce time and expertise away from efforts to address these pressures. … It seems likely that [these] massive organisational changes … contributed to widespread financial distress and failure to hit key targets for patient care.”

While acknowledging that the reforms have led to “greater marketisation” in the NHS, the King’s Fund said “claims of mass privatisation were and are exaggerated”.

In the first of two reports looking at the Coalition’s record on the NHS, the think-tank welcomed a shift in focus towards patient safety under Mr Lansley’s successor, Jeremy Hunt. This came in the wake of the Francis Report into poor care standards at the Mid Staffordshire NHS Trust, as ministers sought to distance themselves from reforms that came to be widely regarded in Government as a major error.

“Jeremy Hunt has taken the lead on damage limitation, studiously ignoring many of the reforms promoted by his predecessor (rarely mentioning competition, for example) and staking his claim as the defender of patients’ interests,” the report states.

The report also praised recent efforts to integrate health and social care services, amid concerns that cuts to care in the community and at home for elderly patients are creating huge pressures for hospitals.

A spokesman for Mr Hunt said the King’s Fund report highlighted “why both the public and the health sector should be wary of Labour’s plans for upheaval and reorganisation.”

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