Lansley defends NHS reforms after scathing report from MPs

 

Health Secretary Andrew Lansley has defended his reorganisation of the NHS, describing a highly critical report by MPs as “out of date” and “unfair” to the health service.

Mr Lansley insisted that the NHS was delivering efficiency savings and improvements for patients following a warning from MPs that the overhaul of the NHS is hindering efforts to slash health spending without cutting vital services.

“I think the select committee's report is not only out of date but it is also, I think, unfair to the NHS, because people in the NHS, in hospitals and in the community services are very focused on ensuring that they deliver the best care to patients and that they live within the financial challenges that clearly all of us have at the moment,” Mr Lansley told ITV Daybreak.

“I am afraid the evidence points to the fact that they are doing that extremely well.”

His remarks follow a highly critical report from the Commons Health Select Committee which said hospitals were resorting to short-term “salami slicing” as they try to find £20 billion in efficiency savings by 2014/15.

In a stinging criticism of Mr Lansley's reorganisation, it said the process “continues to complicate the push for efficiency gains”.

There was a “marked disconnect between the concerns expressed by those responsible for delivering services and the relative optimism of the Government” over achieving cuts, the committee noted.

The attack is especially wounding as the committee is chaired by one of Mr Lansley's Tory predecessors, Stephen Dorrell, and is dominated by Conservative and Liberal Democrat MPs.

Speaking on Sky News, Mr Lansley said delivering improvements in the NHS and efficiency savings required some degree of organisational change.

"I actually think in the NHS it is being very well managed and we are keeping a focus on improving performance," he said.

"There are things happening across the NHS that are really doing well.

"I think, frankly, people working in the NHS, instead of seeing this kind of Westminster nonsense, what they want to see is that people are recognising that they are working very hard, they are saving resources and reinvesting them for the benefit of patients.

"On most of the measures of performance, they are improving that performance."

Mr Lansley told the BBC Radio 4 Today programme that the select committee had not offered specific evidence for its claims.

"Clearly someone can go around the country and say someone's made the wrong decision... frankly, sometimes, they make the wrong decisions," he said.

"But of course we have 150 different places across the country where they have to make decisions about local priorities and it's not my job to try and second-guess all of those.

"But the principle is absolutely clear - we are delivering efficiency savings in order to reinvest for the benefit of patients.

"So, there is no point, it is self-defeating to cut services for patients in order then to reinvest to improve them."

Mr Lansley said the Health and Social Care Bill was supported in principle by many NHS professionals.

"Where we are is there has been support for the principles of what we are doing, including from many of the professional organisations," he said.

The MPs' report comes days after all the major health unions - representing doctors, nurses and midwives - stated "outright opposition" to the Health and Social Care Bill being debated by Parliament.

The British Medical Association (BMA), the Royal College of Nursing (RCN) and the Academy of Medical Royal Colleges are also holding a summit on Thursday to discuss the Bill.

For today's report, a detailed investigation by the committee found "disturbing evidence" that cost-cutting measures being implemented "could fairly be described as 'short-term expedients' or 'salami slicing"'.

NHS bodies were "making do and squeezing existing services simply to get through the first year of the programme" rather than looking for long-term reforms to practices, it found.

In a stark warning, the MPs concluded that it was "far from certain whether the targets... will be met, even with trusts stretching themselves".

The tough task was being made harder by the fact that the Government was pushing through its major shake-up of the entire health service structure at the same time, the MPs said.

"Although it may have facilitated savings in some cases, we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings," they concluded.

The Department of Health also came under fire in the report for giving NHS bodies only weeks to prepare bids for £300 million of capital funding over the Christmas period.

"At a time when all NHS bodies are being required to make efficiencies and need to plan strategically to reshape services, it is unhelpful for the Department of Health to require them to make bids for capital funding to short deadlines and without adequate preparation," it said.

As part of an examination of the state of social care, the committee said there was "precious little evidence of the urgency" required being given to integrating health and care services.

It expressed "deep concern" that £116 million of £648 million earmarked to improving the link between the two had been spent simply "sustaining existing eligibility criteria".

It called for urgent investigation of the possibility of "passporting" more NHS funds directly to the sector - and warned that more vulnerable people were losing out on state-funded help.

"In spite of Government assurances, local authorities are having to raise eligibility criteria in order to maintain social care services to those in greatest need," it said.

Mr Dorrell attempted to play down the significance of the impact of the Government's reforms, insisting the NHS was "well used to management change" and that efficiencies were the "key issue".

"The fact that there is another Bill going through Parliament changing the management structure of the NHS means that there is a tendency for every comment about the NHS to be framed by the debate about the Bill," he said.

"But the NHS is well used to management change. In reality, the key pressures which are building in the system arise from the fact that demand is continuing to grow at a time when health and social care budgets have stopped growing.

"The NHS funding challenge can only be met by rethinking and redesigning the way health services are delivered now, in order to deliver lasting long-term benefits."

Commenting on the MPs' report during a visit to McDonald's UK headquarters this morning, Nick Clegg said the Government should not back off from changing the NHS.

The Deputy Prime Minister said: "We have addressed all the main concerns that people understandably had at the beginning and I think we shouldn't now back off from improving and updating and modernising the NHS.

"We have been very explicit in the last few months in saying we are not going to privatise it, we are not going to chop it up through the inappropriate application of competition, we are going to make sure it is properly accountable and so on.

"We now want to see the Bill turned into practice, where we can give GPs, nurses and others a greater say and more freedom in providing top-quality care to patients up and down the country."

PA

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