miércoles, 19 de enero de 2011

Health and social care bill based on 20900 NHS redundancies - The Guardian

Andrew Lansley
Andrew Lansley's plans mean that than 20,000 staff at PCTs and SHAs are likely to get redundancy payments. Photograph: David Jones/PA

The Department of Health expects the NHS to pay £1.024bn in redundancy costs, as a result of 40% of primary care trust (PCT) and strategic health authority (SHA) staff leaving. The figure is based on 20,900 redundancies and 'natural wastage' of a further 3,600 staff leaving for other reasons.

The figures were published by the department in a supporting document to its health and social care bill on 19 January. A central part of the bill involves abolishing PCTs and SHAs by April 2013, with healthcare commissioning in England taken on by GP commissioning consortia.

If the proportion of staff leaving rises to 50% – a possibility considered in the supporting document – the redundancy costs would rise to £1.288bn. The bill includes provisions for the remaining PCT and SHA staff to transfer to a wide range of NHS bodies, but also local authorities – who are taking responsibilities for public health – and other public authorities with health responsibilities. It also allows staff to transfer to qualifying companies, and SHA staff may transfer to Monitor, the regulator for foundation trusts.

Redundancy payments will make up the lion's share of the cost of the reorganisation of the NHS in England, with an estimated £377m required otherwise, based on £12.5m for each organisation being abolished, a number used by the National Audit Office in a recent report. £264m, or 70%, of this will go on IT and accommodation costs.

Health secretary Andrew Lansley said the £1.4bn estimated overall cost would lead to annual savings of £1.7bn by 2014-15. "We are determined to set running cost limits," he said, adding that these will be managed by the new NHS Commissioning Board. He added that these are likely to be in the order of £1.3bn, at the lower end of £25 to £35 for each patient served by what he referred to as "GP-led commissioning consortia".

Asked whether he is abolishing PCTs and SHAs too quickly, Lansley replied that the government has adjusted its plans by establishing pathfinder consortia as quickly as possible, giving those now in place more than two years before they take up their responsibilities. There are now 141 pathfinder schemes, covering around half the English population.

Lansley added that he was pleased by the variety of consortia in the pathfinders, which range from single GP practices to some covering a whole county. He said: "The beauty of the legislation is, that can change", during the two year process. There is also provision in the bill for the national board to run commissioning in an area, if any GP consortia are not ready by spring 2013.

He dismissed the idea that the government should have simply given GPs greater powers over PCTs, rather than carry out such a significant reorganisation. "The abolition of PCTs is simply the consequence of form following function," Lansley said, through giving GPs responsibility for commissioning.

This article is published by Guardian Professional. Join the Guardian Healthcare Network to receive regular emails on NHS innovation.

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