Reports highlight fears of compromised clinical care and threat to children as BMA calls for privatisation plans to be withdrawn
The government's shakeup of the NHS has led to a decline in public confidence, "may destabilise existing services" and has raised risks to patient safety and safeguarding children to disturbing levels, the Guardian can reveal.
The risk assessments, which are publicly available, were prepared for the September board meetings of regional strategic health authorities and detail the scale of uncertainties and the chances that they will substantially affect the running of the health service for patients.
They come as the NHS published its "operating framework" in which £1.2bn will be set aside to pay for the government's reforms. Two controversial changes also come into force this year. First is that patient "choice" will be measured by an increasing "number of patients being treated at non-NHS hospitals", which critics say amounts to backdoor privatisation.
Second is that GPs will no longer get extra cash for having needy patients. Instead family doctors will receive a £25 a head "running allowance". That means GPs in poor areas will lose about £12,500.
Many parts of the health service are becoming openly unsettled by uncertainty. In NHS London, the risk assessment says winter plans may not be "sufficiently robust" and that could mean "compromised clinical care and patient safety". If in the capital the NHS fails in its "capacity planning" for maternity services, there "is a risk that women may be exposed to unsafe services/systems/processes which could cause them harm". There is a warning that the consequences of closing NHS trusts with the departure of experienced staff "may be preventable harm to children".
In York and Humber, there has been a "decline in levels of public confidence in the NHS locally". There was concern over "organisation and system instability due to transition following publication of the white paper".
In the east of England, the report issues a red alert because the transition to the coalition's view of the NHS "may destabilise existing services if we fail to identify commissioning arrangements in the new system and/or if lack of capacity jeopardises continuity".
Many parts of the NHS are acting on the risk assessments to ensure that worst-case scenarios do not materialise. For example, NHS South Central – which covers trusts in Berkshire, Buckinghamshire, Oxfordshire, Hampshire and the Isle of Wight – admits frankly that it could fail to "deliver targets" required by the Department of Health, although it will now report waiting times each week to get on top of the problem.
The information came as the British Medical Association called on the government to withdraw plans to privatise support services for clinical commissioning groups in England. Its ruling council requested an urgent meeting with the health secretary, Andrew Lansley, over plans for these services to be provided solely by large private firms after 2016.
Dr Hamish Meldrum, chairman of the BMA council, said: "A key plank of the government's NHS reforms was to entrust GPs and other healthcare professionals to lead on the commissioning of services for patients to ensure local health needs were met. These latest proposals from the government have the potential to seriously undermine this role."
Labour's shadow health secretary, Andy Burnham, welcomed the BMA's opposition to the reforms.
He said: "Their decision to launch a campaign is conclusive proof that the government has abjectly failed to build professional consensus behind its reckless reorganisation."