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Responding to the publication of the Health Select Committee’s report on public expenditure, John Appleby, Chief Economist at The King’s Fund, said:

‘The Committee is right to stress that meeting the Nicholson Challenge is the most important priority facing the NHS, despite the headlines generated by the health reforms. The report should serve as a wake-up call for ministers and the NHS about the magnitude of the task ahead. If delivering the productivity improvements required is challenging now, it will only get more difficult during a financial squeeze that is set to last several years.

‘We share the Committee’s concern that too much emphasis is being placed on finding short-term financial savings instead of delivering real improvements in performance and productivity. This is a big challenge but there remain significant gains to be made by tackling unwarranted variations in NHS performance.

‘Changes to hospital services in some parts of the country are now a necessity, not an option. While recent announcements signal a welcome willingness from ministers to embrace the reality of this, this should be followed by an honest dialogue with the public about the need for change. As we pointed out in our recent report about the situation in London, it is also not clear who will be responsible for leading major reorganisations of services under the proposals set out in the Health and Social Care Bill.

‘The Health Select Committee’s report also lays bare the challenge for local authorities struggling to maintain social care services in the face of cuts to their budgets, once again hammering home the case for acting on the Dilnot Commission’s proposals. As the Committee points out, a more ambitious approach is needed to promote health and social care integration – this should focus on pooling local budgets and, potentially, moving towards a single assessment of the funding needs of the NHS and social care.’

Notes to editors

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