Implementation of the NHS Reforms

The beginning of April saw the implementation of what are largely heralded as the most significant NHS reforms since its foundation in 1948.

This has seen GP-led clinical commissioning groups taking control of local budgets and a new body NHS England (previously known as the NHS Commissioning Board) overseeing the new commissioning landscape with the aim of improving health outcomes for the people of England.

The reforms aim to bring clinical expertise to the fore of decision-making by placing GPs in control of a large proportion of the NHS budget (£65 billion): deciding the health services to commission and how best to deliver healthcare.

Yet many are concerned that the reforms may lead to the privatisation of the NHS.

Private companies may cherry-pick the services that they wish to provide and leave only the unprofitable services to be delivered by the public sector. Sceptics are concerned that this may lead to an even more perilous outlook for the financial future of the NHS.

In addition many are concerned about conflicts of interest as over a third of GPs in an executive role in the new commissioning structure have a financial interest in a for-profit private provider (beyond their own GP practice).

But so long as mechanisms are in place to prevent any favouritism arising in practice and the NHS remains free at the point of use does it really matter whether services are provided by the public or private sector? For many this is immaterial and some even appreciate that private sector providers may help to drive up standards and bring innovation and efficiency. Over the coming months we shall begin to see the impact of the reforms in practice and we can then decide whether their significance is more than surface deep.

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