NHS bill is a mess, says former chief executive

Lord Crisp Lord Crisp said the bill was "confused and confusing"

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A former NHS chief has told the BBC that controversial proposals for the health service in England are a "mess" and "will set the NHS back."

Lord Crisp was both NHS chief executive and the permanent secretary at the Department of Health from 2000 to 2006.

Labour's Andy Burnham said the crossbench peer's words were "pretty devastating for the government".

The government says its plans will modernise the NHS, improve services and reinvest savings in front line care.

The Health and Social Care Bill gives GPs control of much of the NHS budget and opens up the health service to greater competition from the private and voluntary sector.

It has completed its Commons stages but is having a difficult passage through the House of Lords, which has tabled a number of amendments, and is being opposed by many groups representing medical professionals.

'Great mistake'

Lord Crisp told BBC Radio 4's The World This Weekend: "I think it's a mess ... I think it's unnecessary in many ways, and I think it misses the point."

He said the bill should set out the "direction of travel of the NHS" - towards more community and "prevention-based" healthcare - and the ways that should be achieved, with some use of the private sector "but much greater emphasis on integration".

He believed the bill was "unfortunately setting the NHS back"

"I think the great mistake that the current government has made - and I can say this as an independent and not a politician - is that this is a terrible confused and confusing bill.

"It has tried to elevate the ideas of competition and the use of the private sector, which are just mechanics, just mechanisms, as if they were the purpose."

Shadow Health Secretary Andy Burnham said: "The government has now suffered the humiliation of a former Department of Health permanent secretary and NHS Chief Executive labelling this Bill a mess that risks setting the NHS back.

"It's clear that this is now just about saving face for David Cameron and Nick Clegg, not what's best for the NHS. They are forcing on to the statute book a busted flush of a Bill despite clear warnings from patients and professionals that it will damage the NHS."


A Department of Health spokesman said: "Our plans will harness the expertise of local doctors and nurses, who know better than anyone what their patients need.

"The proposals promote health in partnership between the NHS and local communities and put local authorities in the driving seat alongside clinicians for improving the health of their communities.

"Improving integration between all health and care services is a crucial part of modernising the NHS."

Start Quote

All of us, not just the health secretary, have to be better at selling these reforms”

End Quote Andrew Mitchell International Development Secretary

But a source at the department told the BBC they were "disappointed" at the criticism from Lord Crisp.

There has been much Lib Dem unease about the bill - last week the party's president Tim Farron called for the whole section dealing with increased competition to be dropped.

In a Sunday Mirror article Labour leader Ed Miliband urged Lib Dem peers to support Labour in an effort to kill off the Bill in the House of Lords.

But Lib Dem deputy leader Simon Hughes told the BBC there would be amendments from Lib Dem peers in the Lords "which will make sure we are not subject to European competition law and we don't have anything like a 49% upper limit to private practice" in the NHS.

Forty Conservative MPs wrote to the Sunday Telegraph praising the principles of the bill, without mentioning Andrew Lansley - something the newspaper suggests is a "snub" to the health secretary.

But Conservative MP Dan Poulter, who helped organise the letter, told the BBC it supported the bill and so "inherently" supported Mr Lansley, who, he said, "understands the NHS".

International Development Secretary Andrew Mitchell told the BBC the reforms were born out of a "total commitment" to improving the NHS at a time of increased life expectancy and rising medical costs.

But he added: "All of us, not just the health secretary, have to be better at selling these reforms."


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  • rate this

    Comment number 86.

    I think that most of us would agree that the NHS could be more efficient BUT this government doesn't have a clue as to how to achieve this.

    In my experience large change programmes are very difficult to deliver but without the backing of a very large proportion of the organisation they run hugely over budget and do more harm than good.

    IMO this initiative is now in this situation

  • rate this

    Comment number 79.

    To me something this important should not be rushed through and this coalition is trying to bulldoze it through to me if its going to cut top management then i agree with it and put patient first and foremost . mavis

  • rate this

    Comment number 66.

    I've read through the bill and unless I'm mistaken, as a NHS patient I can still:

    a) See a GP free of charge
    b) See a specialist consultant free of charge
    c) Have an operation free of charge
    d) Receive post-operative outpatient care free of charge

    If this is incorrect can someone please point out the relevant sections in the bill that contradicts any of the above.

  • rate this

    Comment number 30.

    There is no clear distinction between private and public health care. That's the problem.

    Cameron is making it worse because of the mantra that the private health care systems are working. Where's his evidence it works without NHS funding and run by NHS trained doctors/nurses etc?

  • rate this

    Comment number 24.

    All the medical societies, groups and organisations that treat and heal us are wrong in opposing the bill of course, they don't know what they are talking about, the British people are all wrong too, even more clueless!

    It is Andrew Lansley and the private health companies that have it right, they are the ones to trust!


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