Study urged on whether NHS changes worthwhile

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A PROPER study is needed on whether the extra administrative costs of the National Health Service changes have been worthwhile, Andrew Foster, the NHS's former deputy chief executive, indicated yesterday.

Mr Foster, now controller of the Audit Commission, told a conference in London on quality in the NHS that there were some 'very legitimate questions' to be asked about whether it was getting value for money from the changes.

The Audit Commission has acted as a public spending watchdog to the NHS since the health service changes came in and is charged with checking the efficiency, effectiveness and economy with which the NHS spends its cash. But it has not launched an overall study of whether the changes are proving value for money.

Hundreds of millions of pounds - up to pounds 1.2bn on Labour's calculations - have been spent introducing the changes. But the Audit Commission has only looked at them institution by institution. Asked by a Glasgow GP at yesterday's conference whether there should not be an overall study, Mr Foster said there were strong arguments for 'a total piece of work', although such a study would inevitably be 'highly politically charged'.

He added, however, that 'significant changes have been happening (in the NHS) and there are very legitimate questions to be asked'.

His comments came as Martin Buxton, Professor of Health Economics at Brunel University, said there was little evidence that the millions of pounds provided for medical audit under the NHS reforms have proved value for money.

To date, pounds 160m has been provided for medical audit in which doctors review each others' performance in order to raise the standards and quality of treatment.

Professor Buxton, however, said there was very little good evidence that it was improving the quality of care. Because it was seen to be a 'laudable activity' it had been heavily funded, 'but it is not more obviously a good thing than any unproven new drug'.