Commissioning : Fourth report of session 2009-10, Vol. 1: Report, together with formal Minutes

Systematically updated throughout, the 6th edition of this leading text takes the story of health policy to the end of the Blair era and into the early years of the Brown premiership. It offers a clear and thorough introduction to the history of the NHS, its funding and priorities, and to the process of policy making.

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.

Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty