NHS reforms 'hindering drive to make savings'

The overhaul of the NHS in England is hindering its ability to make the savings it needs to safeguard its future, MPs have said. The NHS has been told to save £20bn by 2015 through improving productivity. But the health select committee said the planned reforms were "complicating" the process because they were acting as a "disruption and distraction". Health Secretary Andrew Lansley says his reforms were "essential" for improving the NHS. Last week unions representing midwives and nurses joined the British Medical Association (BMA) in urging the bill behind the changes be scrapped. There is mounting concern about the government's plans which will see GPs take control of much of the NHS budget and greater competition encouraged with the private sector. Opposition On Thursday a meeting of all the royal colleges and unions is being held to discuss the next steps in opposing the changes. The health committee report was not specifically looking at the reforms. Instead it focused on how the NHS was doing in achieving the efficiency savings it has been asked to make. While the health budget is being protected, savings are still having to be made to keep pace with the rising costs associated with the ageing population, cost of new drugs and lifestyle factors, such as obesity. The concerns of the cross-party group of MPs was first reported in the press on Sunday ahead of the report's publication. And Deputy Prime Minister Nick Clegg has said the planned reforms must go ahead, despite the fresh criticism from MPs. The MPs said there were strong concerns about the ability of the NHS to make the savings - the equivalent of 4% a year. It said there had been too much emphasis so far on short-term cuts and "salami-slicing", instead of re-thinking the way care is delivered. And it argued there needed to be more integration with social care to stop people needing hospital treatment, which tends to be more expensive. But it warned that in some ways the opposite was happening as councils were increasingly restricting access to services. 'Key pressures' John Appleby, chief economist of the King's Fund, a charity that seeks to shape NHS policy and practice, said: "The report should serve as a wake-up call for ministers and the NHS about the magnitude of the task ahead." And Mike Farrar, of the NHS Confederation, which represents NHS managers, agreed. He said there was a lot of "uncertainty" in the NHS at the moment that was dangerous. "The NHS faces a once-in-a-generation financial challenge that is still to be explained properly to the public," he added. Rachael Maskell, of the Unite union, said the report should be the "final nail in the coffin" for the bill. Dr Hamish Meldrum - the BMA's chairman of council - says the plans will prove harmful to patients. "The health select committee say it's distracting - we would say it's completely unnecessary and somewhat dangerous. "As the health select committee say, it's taking everybody's mind off the real issues, which is trying to run an efficient health service, trying to make changes to the health service for the benefit of patients, and, at the same time, trying to identify savings." Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, says the plans will pose a threat to patient safety and the future of the NHS itself. "We completely concur that money has to be saved. We've never disputed that, it's the way they're going about it. "What you're seeing here is a whole raft of short-term, ill thought-through cuts that are going to stack up problems - not in the long-term, but in the medium-term." Patient priorities The committee is chaired by Conservative former health secretary Stephen Dorrell, who said every comment about the NHS tended at the moment to be framed by the debate about the bill. "But the NHS is well used to management change," he said. "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." He also said the need to achieve efficiency savings in the NHS was paramount, and that the bill must come second. "The priority is to deliver more efficient care, in order to meet demands placed upon the system - and the implementation of the bill has to fit in around that," he said. "Patients have to come first, within the resources available. "The only way you can meet the demands placed upon the system by patients is by changing not the way the system is managed, but the system itself." Mr Lansley said the government's plans for modernisation "are essential if we are to put the NHS on a sustainable footing for the future". He told the Today programme: "We have to deliver more care in the right place at the right time. That means more care in the community. "There's been support for the principles of what we're doing, including from many of the leading professional organisations. "The legislation's not completed its passage, the Lords are making many significant and constructive suggestions, and we will take those on board, but the principles of the bill are widely supported."