NHS reforms could cost £3bn with no guarantee of better care, warns expert

Released 16/07/2010

NHS reorganisation debate continues

The government's radical reorganisation of the NHS in England is likely to cost between £2bn and £3bn to implement with no guarantee that it will improve performance or lead to better care for patients, warns an expert in an editorial published on bmj.com today.

Kieran Walshe, Professor of Health Policy and Management at Manchester Business School says that there is very little evidence that past NHS reorganisations have produced improvement and argues the new government "looks likely to make all these mistakes again."

Few NHS reorganisations have been properly evaluated, writes Walshe, but a recent National Audit Office study of over 90 government reorganisations found that, despite huge costs, the benefits were unclear, the process was often poorly managed, and that its impact on performance was often adverse.

He says reorganisation can "adversely affect" service performance and be a "huge distraction from the real mission of the NHS" - delivering healthcare and improving healthcare quality. Walshe also argues the reorganisation risks absorbing a "massive amount" of managerial and clinical time and effort.

Walshe urges the government to produce evidence to justify the case for change. "The intended costs and benefits must be made explicit and measurable...and a systematic analysis of the impact of the reorganisation should be produced within two years of its implementation and presented to parliament."

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