MiP calls on the Government to abandon its Health Bill

Wed 08 Feb 2012

‘MiP has always been opposed to the Bill, because it is risky, unnecessary and costly. Nothing has happened to change our minds,’ says MiP chief executive Jon Restell

As the Health and Social Care Bill returns to the House of Lords, Jon Restell said:

‘The Government should do itself a favour and abandon its plans. Instead it should talk to the health service about how to safeguard quality care and meet extra demand when there is no new money.’

MiP has again written to peers setting out our main concerns about the Bill, and the text is reproduced below:

MiP is the representative body for nearly 6,000 senior health service managers including over 200 Chief Executives working in all areas of healthcare. MiP members are at the forefront of current health service commissioning and NHS delivery of efficiency and patient outcomes and are very well placed to inform the debate on the future of the NHS.

The NHS reorganisation proposed by the Health and Social Care Bill will be the biggest shake up of the NHS since its inception. MiP agree with the recent joint editorial of BMJ, Nursing Times and HSJ that the upheaval the Bill is creating is “unnecessary, poorly conceived, badly communicated and a dangerous distraction at a time when the NHS is required to make unprecedented savings.”

The experience of MiP’s members - at the forefront of delivering quality, innovation, productivity and prevention (QIPP) and seeking to improve patient outcomes – also vindicates the recent Health Select Committee Inquiry conclusion that the re-organisation complicates the push for efficiency gains by creating disruption “that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings.“

 As managers we see other significant risks with this upheaval:

  1. The risk that the reforms will not succeed even on the Secretary of State’s own terms

    The Government’s own risk assessment identifies major potential pitfalls including:
  • “Clinical Commissioning Groups [CCG] not having the capacity and capability to engage with and deliver clinical commissioning”;
  • “Potential conflicts of interest between CCG members as providers and commissioners of patient care;”
  • “Potential higher transaction costs as we change the number of organisations commissioning services”
  1. The risk associated with introducing wholesale competition into every aspect of the NHS.  

    MiP is not against all competition, however its introduction must be tightly managed to ensure that it is having the desired effect – improved outcomes for patients. Despite the concerns raised up to, and within, the Future Forum report, the current Bill still places an over emphasis on competition to improve performance. MiP’s view is that there is a greater need to promote collaboration and integration to ensure we can meet health needs of the population and to achieve the necessary reconfiguration of acute services.

  2. The risk of introducing such change and making savings at the same time as massively cutting management.

    For example, when it was announced that the new national Commissioning Board will have 50% less staff than the bodies it is replacing, MiP warned that Ministers are getting rid of the very people who can deliver the Government's efficiency plans, maintain high quality and safe services for patients and save £20 billion. Mike Farrar, Chief Executive of NHS Confederation, also said such reductions in staffing levels could reduce NHS capacity “to dangerously low levels”. Meanwhile the Government is moving towards its target of cutting managers by 45% - despite the findings of ‘The Future of Leadership and Management in the NHS’ Kings Fund Commission which concluded the NHS may actually be “under-managed” and warned that the numbers used in these targets are “simply arbitrary” and “backed by no published analysis whatsoever”.

 Managers in Partnership has consistently argued that the goals of a more clinically led and patient focused NHS could be achieved – along with greater integration and significant costs savings – through the reform, and clustering, of PCTs and SHAs and without this new unsettling legislation. The Bill should therefore be withdrawn.

MiP would be pleased to provide further information in relation to any of the issues above and/or to meet with you to explain our concerns in greater detail. Please contact Steve Barwick on Steve@connectpa.co.uk or Marisa Howes, Managers in Partnership, on 020 7121 5167.





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