This review summarizes the new arrangements for the NHS proposed in the Health White Paper (Cm. 7881, ISBN 9780101788120). In that paper the Government proposed a number of reforms to the structure and operation of the NHS, which have since been refined and developed in 'Liberating the NHS: legislative framework and next steps' (Cm. 7993 ISBN 9780101799324). The Health and Social Care Bill is designed to create the necessary legislative change. The review's purpose is to inform the Public Accounts Committee so that it can take stock of the proposals as they currently stand and discuss their implementation with the Department of Health and NHS.

This report examines the value for money risks and implications of the Health and Social Care Bill. The Bill proposes a new model for the NHS focusing on patient outcomes. The proposals are intended to transform the NHS in England into a highly devolved, market-based model in which local commissioners and providers of health services are freed from central control, with an increased say for local authorities, patients and the public. Whilst the reforms could complement the imperative of achieving £20 billion efficiency gains by 2014/15, the reorganisation presents an additional challenge for the NHS. The health reforms are still at an early stage and key questions have yet to be addressed. It is vital that the Department creates robust accountability structures so that Parliament and the public can properly follow the taxpayers' pound and hold those responsible to account. The Committee is concerned that the Department has not yet developed a high quality risk management protocol for either the commissioning or providing bodies. The Department acknowledges that some health trusts and some GP practices have some way to go to achieve foundation trust status or become commissioning consortia. The Department must have effective systems in place to deal with failure so that whatever happens, the interests of both patients and taxpayers are protected. This report provides an overview of aspects of the reforms where Parliament requires clarification and draws out a number of risks associated with the transition to the new model that need to be managed.

The New Public Health has established itself as a solid textbook throughout the world. Translated into 7 languages, this work distinguishes itself from other public health textbooks, which are either highly locally oriented or, if international, lack the specificity of local issues relevant to students' understanding of applied public health in their own setting. This 3e provides a unified approach to public health appropriate for all masters' level students and practitioners—specifically for courses in MPH programs, community health and preventive medicine programs, community health education programs, and community health nursing programs, as well as programs for other medical professionals such as pharmacy, physiotherapy, and other public health courses. - Changes in infectious and chronic disease epidemiology including vaccines, health promotion, human resources for health and health technology - Lessons from H1N1, pandemic threats, disease eradication, nutritional health - Trends of health systems and reforms and consequences of current economic crisis for health - Public health law, ethics, scientific d health technology advances and assessment - Global Health environment, Millennium Development Goals and international NGOs

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Currently, 340,000 people, or 30 % of eligible care users, have a personal budget, which enables the individual to choose their care provider. The Government wants all eligible users to be offered a personal budget by April 2013. Personal budgets currently cost the taxpayer £1.5 billion each year. The total annual expenditure on care is around £23 billion. Effective oversight of the care market is essential to protect the interests of both social care users and of taxpayers. There is growing consolidation in the social care market at a regional level. Yet the Department did not have a view on what level of market share represents a risk of provider dominance, or arrangements to protect users should a large-scale provider fail. This is worrying given the recent experience of Southern Cross and the high levels of debt that some providers are carrying. There are risks to the future functioning of the social care market from local authority budget reductions. The report notes some difficult areas with personal budgets: provision of advice, ease of changing support, redress. The Department has to rely on local authorities to implement its policy of universal provision of personal budgets but it cannot compel local authorities to act. The Department will shortly issue a White Paper on reforming social care delivery. The changes the Department makes must address concerns about giving users a real choice, overseeing the market to ensure competition and stability, and putting in place arrangements and contingencies to deal with major provider failure.

The Commons Public Accounts Committee publishes its 54th report of Session 2010-12, on the basis of evidence from consumer groups, the Department for Business, Innovation and Skills, the Office of Fair Trading, and the Trading Standards Institute, examining the current arrangements for the enforcement of consumer law, and the proposed changes to the regime. Individual consumers lose around £6.6 billion every year because of the malpractices of traders. At least £4.8 billion is lost through malpractices which occur at a regional or national level, such as mass market scams, counterfeiting, and unscrupulous traders who operate over large geographical areas. The Department has overall responsibility for policy on consumer protection. However, the majority of enforcement work, from weights and measures testing to the prosecution of rogue traders, is carried out by local authority Trading Standards Services, each with jurisdiction in only its own local area. The Committee states, that the Department has limited understanding of the true cost of protecting consumers or of the success of existing interventions. There is no clear and complete information on how much enforcement activity actually costs. The approach to enforcing consumer protection has not kept pace with the changing nature of the problems it is intended to tackle, such as online shopping. Any changes the Department makes must deliver a system fit for the modern era. Responsibility for tackling regional and national instances of malpractice or rogue trading must be clearly designated.

The Department for Education is distributing £56.4 billion in 2011-12 to schools, local authorities and other public bodies for the delivery of education and children's services in England. The Department has set out how it intends to provide Parliament with assurance about the regularity, propriety and value for money in an Accountability System Statement (the Statement) of which the Committee has now seen three drafts. Responsibility for value for money is shared by the Department with schools, academy trusts, local authorities, the Young People's Learning Agency and the Department for Communities and Local Government. However, the Statement does not yet clearly describe the specific responsibilities of each body, how these will interact, or how the Department will assess value for money across the entire education system. The Department relies on local authorities and the YPLA to exercise financial oversight over local authority maintained schools and academies respectively. However, oversight by some local authorities is currently weak and could worsen as many authorities reduce the resources they devote to overseeing their schools. There are also concerns about whether the YPLA will have the right skills, systems and capacity to oversee the rapidly increasing numbers of academies expected in coming years. More consistent requirements for data and data returns must be applied to all schools so that academic and financial performance can be benchmarked, and all schools can be held accountable. The Department needs to enforce these requirements more stringently, particularly given previous problems with lack of compliance