Reformers and Reactionaries

By Thomas Cawston, Researcher at Reform

Last week Reform made Andrew Lansley its “prestigious” Reactionary of the Week for his decision to halt the NHS London plan to redesign services to deliver quality care and reduce costs. Today we have our Reformer. The resignation of Sir Richard Sykes, Chair of NHS London, on account of Andrew Lansley’s decision, demonstrates the level of anxiety among NHS leaders about the Government’s health policy. Already the decision has echoes of Tony Blair’s and Frank Dobson’s decision in 1997 to dismantle some of the reforms of the previous Government.

Before the election there was a growing consensus in health policy that the NHS would have to undergo significant reconfiguration. As Reform’s March report Fewer hospitals, more competition argued, redesigning services is consistent with the long term change in health needs. The key challenge of a modern healthcare system is to improve the quality of life for people with long term conditions. This means the NHS needs new innovative ways to deliver treatment. Medicine has changed and health services need to change with them.

With the NHS facing a £20 billion funding gap by 2014 the case for service reconfiguration was indisputable. After years of consultation and research the Strategic Health Authority plans would have brought service redesign to deliver quality, innovation and productivity in the regional health system. This was the latest in a succession of reviews over the last few decades that have all advocated hospital closures.

NHS London led the way. London is facing £5 billion in real term cuts by 2017, with hospitals required to deliver savings of £2.4 billion. The capital has an unsustainable number of hospitals, as Sir Richard Sykes claims “the current configuration of hospital services is not making best use of taxpayers' money”. The SHA plan would have sought to reduce the number of hospital beds by a third and to close one in three A&E facilities. 75 per cent of all visits to casualty and 50 per cent of all out-patient appointments would be dealt with a network of 100 modern polyclinics. Only through these changes could the NHS in London reduce costs and improve services.