Comprehensive Spending Review: NHS - The challenge of being singled out

The Government NHS white paper, published in July 2010, set out an ambitious programme for change, shifting the responsibility and accountability for the purchasing of health services to groups of local GPs. Regardless of whether GPs welcome this new role or have the capability to take it on, Osborne’s approach in the CSR to the funding of the NHS over the next four years may well have made their job a difficult one.

Craig Barratt, Director of Healthcare Advisory at BDO LLP, said of today’s CSR announcement:

"By singling out the NHS for special treatment and perceived investment, the public will now expect local healthcare services to be protected. High expectations of public services is a positive thing. However, when such significant change needs to be delivered in such a short space of time, a public that has been told the NHS has been protected will not expect the closure of its local hospital or longer waiting times for operations. Heightened public expectation will, in effect, make the job of delivering potentially controversial but essential change at a local level much more difficult.

"A reduction in funding, or at least a clearer explanation of the challenges the NHS will face, would have given greater permission for GPs and managers to act. Combine this with a pay freeze for a significant number of NHS staff and an increase in pension contributions, the radical changes required may well be delivered more slowly than planned.

"In accepting this challenge, GPs and NHS managers must pro-actively involve the public at a local level, explaining clearly why change is required. They have to make "No decision about me, without me" a reality, not simply a slogan."

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