NHS Reform Report: National Mantra, Not Local Reality, by Nick Bosanquet, Professor of Health Policy at Imperial College London
Thursday 03 April 2008Comment on this article Permlink
Professor Bosanquet argues that while the Government’s commitment to NHS reform is right, it is in denial about its progress on the ground.
The report, published by the independent think tank Reform, shows that reform is the only way to unlock the value of the NHS budget but the Government’s programmes remain embryonic, and in some cases in full retreat.
The solution is an economic constitution which defines duties to create value at all levels of the service.
The report uses recent studies to show that the performance of the NHS across the lifespan is well behind other countries.
Improving patient care will need new investment in many areas, but taxpayer funding is (and should be) restricted in coming years.
Bosanquet sees greater productivity as the answer to this strategic challenge.
The report defines two scenarios. Current trends will lead to the negative scenario – “Managing NHS decline” – in which the service delivers substandard quality and access for 11-12 per cent of GDP (c. £110 billion – c. £120 billion). An outflow of talented staff would increase difficulties.
In the positive scenario – “NHS opportunity” – reform delivers immediate access to excellent quality services at a cost of 9-10 per cent of GDP (c. £90 billion – c. £100 billion).
The key, according to the report, is an economic constitution which requires value for money and guarantees patient choice and a diversity of providers.
If it were the key conclusion of the Department’s current landmark NHS review, it would deliver significant improvement within 18 months.
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