The coalition government is to publish its “high risk” NHS Bill to revamp the health service later today amid warnings that Primary Care Trusts are already starting to implode as staff leave “in droves”.
 

The Health and Social Care Bill, which will be laid before Parliament this afternoon, paves the way for GPs to seize control of most of the NHS’ budget from Trusts by 2013.
 
A letter signed by six healthcare unions, which includes the British Medical Association and the Royal College of Nursing, that was published in the Times earlier this week warned that the “sheer scale of the ambitious and costly reform programme, and the pace of change” combined with demands to make £20 billion in savings was “extremely risky and potentially disastrous”.
 
But the government will argue that the changes will improve patient care and accountability. Ahead of the publication of the draft legislation, Health Secretary Andrew Lansley told the BBC: “Our ambition is simple – to deliver care for patients, which is the best of anywhere in the world on the NHS.”
 
A report on commissioning published by the Health Committee yesterday warned that the approach adopted by the government was not the most effective way to deliver on the so-called ‘Nicholson Challenge’, however. In 2009, NHS chief executive Sir David Nicholson told the health service that it would need to achieve efficiency gains of 4% year-on-year, the equivalent of £15 to £20 billion over four years as funding increases dropped.
 
The report said: “The failure to plan for the transition is a particular concern in the current financial context. The Nicholson Challenge was already a high-risk strategy and the White Paper increased the level of risk considerably without setting out a credible plan for mitigating that risk.”
 
The BMA also raised concerns about the scale and pace of the planned changes. Dr Laurence Buckman, chairman of the union’s GP’s Committee, said: “The speed of the reforms means PCTs are imploding as staff leave in droves and those managers who are left are focused on delivering the reforms rather than efficiency savings and the maintenance of patient care.”
 
There was a risk that the potential benefits of clinically-led commissioning could be lost because “key components of the Health and Social Care Bill will make effective collaboration between doctors very difficult”, he added.