Leading experts on the NHS gather for debate on reforms

Posted on 12/11/2012

Leading experts on the NHS gathered at Royal Holloway to debate some of the key controversies surrounding the Government’s radical health service reforms on Thursday evening (8 November 2012).

The ‘Whose NHS?’ event, organised by the Centre for Social Sciences   was open to members of the public, staff and students and included Professor Julian Le Grand, a former senior policy advisor on the NHS to Tony Blair, Andrew Liles, Chief Executive of Ashford and St Peters NHS Foundation Trust, and Professor Mark Exworthy. Professor of Health Policy and Management at Royal Holloway on the panel. It was chaired by Dr Oliver Heath, Director of the Centre for Social Sciences at Royal Holloway. As expected, the topic fuelled a heated debate with questions asked about proposed mergers, clinical commissioning groups and greater competition with the private sector.

Kicking off the debate, Professor Le Grand outlined his belief that the Government’s proposals were a “debacle” and said there is a “real danger that the system, after a while, will grind to a halt”.

Countering his argument, Mr Liles said that his Trust was in fact in a good position, having gained Foundation Trust status two years ago. He found “co-operation” was the default position within the NHS and stressed that too much private competition in his catchment area would not be the best way forward.

One member of the public challenged Mr Liles about targets to reduce the number of emergency cases arriving at hospitals, arguing that it was wrong to talk about patients in terms of “supply and demand.” This was in light of the fact that the Ashford and St Peters NHS Foundation Trust treated eight per cent more emergency patients than it had planned to this year, resulting in financial penalties totalling £4m. He also said NHS Trusts should be more vociferous when lobbying the Government over funding. Mr Liles responded to the question by saying “short of chaining myself to the front of the hospital and demanding more money for the NHS, I’m not sure what you think we should be doing.”

Mr Liles also spoke about his Trust’s proposed acquisition of Epsom Hospital, which it recently had to halt for financial reasons.

At this point, Professor Exworthy waded into the debate with research by social scientists, which showed that mergers can disrupt organisations for between 18 months and two years. “Mergers are a distraction that probably could be done without”, he said.

A member of the audience then raised the controversial issue of GPs and other clinicians being given much more responsibility for spending NHS budgets, asking the panel: “Are clinical commissioning groups likely to increase the postcode lottery?” In response, Candace Imison, Deputy Director of Policy at The King’s Fund, a charity that works to improve healthcare in the UK, agreed that there was a danger of varying levels of care being provided in different areas. “On the one hand I think there are some phenomenal GP commissioners out there that bring in a new perspective,” she said. “But they are taking on a very different role to the one they’ve had previously. There’s a potential risk of them not knowing what they need to.”

In his closing comments, Professor Exworthy said he hoped that the debate had given the audience a deeper understanding of the issues facing the NHS and its patients. He said: “Two-thirds of the public in a recent poll said they knew nothing or very little about the NHS reforms. If we’ve done anything, we’ve hopefully reduce that percentage by a few points.”

Follow the Centre for Social Sciences on Twitter at @RHULCentreSoSci



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