Commenting on the publication of today's NHS White Paper, the Chief Executive of The King's Fund, Professor Chris Ham, said:
'Today's White Paper represents one of the biggest shake ups of the health system since the NHS was established. The ambitions it sets out for a more patient-focused, clinically led NHS are the right ones. The lesson of the last decade though is that the impact of the reforms will depend critically on how effectively they are implemented.
'Giving GPs responsibility for commissioning care and managing NHS budgets should result in services being more closely aligned with patients' needs. But, while some GPs will seize this opportunity, many others may be reluctant to come forward and lack the skills needed. Setting a deadline for GP consortia to take full financial responsibility for commissioning by 2013 is very ambitious – whether this can be achieved will depend on appropriate support being put in place.
'The White Paper will accelerate the trend towards a mixed economy in the NHS, with foundation trusts freed up to become social enterprises, opportunities for private companies to support GP commissioning and increased opportunities for independent providers to deliver treatment. The ensuing debate must focus on delivering the best outcomes for patients, providing the most equitable and efficient care and, importantly, ensuring that data is available to measure these outcomes.
'Proposals to strengthen the links between the NHS and local authorities and give councils an enhanced role in improving public health are positive. The emphasis on linking health and social care budgets is also welcome. With the NHS facing the most significant financial challenge in its history and substantial cuts to social care budgets likely to follow the Spending Review in the autumn, stronger integration between health and social care services is not just desirable, it is essential.
'The White Paper arrives as the NHS faces the biggest financial challenge in its history – the need to find up to £20 billion in productivity savings to maintain quality and avoid cutting services. The White Paper acknowledges the risks involved in undertaking such wide-ranging reforms. Ministers face a significant challenge in ensuring that effective arrangements are in place to deliver the productivity savings needed and, at the same time, implement the reforms set out in the White Paper.'