Along with many of my colleagues, I have been arguing for years that the current structure of the NHS cannot survive. Giving the health service endless money won’t make a significant difference, unless its core structures are changed.
It is therefore very interesting to see that Matt Hancock, in the middle of the pandemic, has unveiled a package of major changes to healthcare, the essence of which is to reverse the Lansley reforms.
One of the reforms the health secretary is taking aim at is the purchaser/provider split, which I have identified in the past as one of the ‘four crumbling pillars of the NHS’. The split involves regional panels commissioning various services, with hospitals and providers competing for ‘contracts’. But the system does not work and is inefficient in practice, leading to very poor provision for services such as mental health, which are not seen as sufficiently profitable.
Many of the Lansley reforms, such as the purchaser/provider split, had plenty of potential benefits, but they have ended up as a disaster.
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