Posts Tagged ‘change management’

Why the government’s cost estimates for delivering its NHS reforms are wrong

27/02/2012, 08:42:23 AM

by Paul Crowe

The Lib Dems are tabling hostile amendments in the Lords, the former chief executive of the NHS has broken ranks to voice his disapproval and the BMA is balloting on industrial action.

Just another day in the progress of the health bill.

As the lords set to work on the bill later today, the focus will be on amendments on competition in the health sector.  But as the debate progresses they would also do well to focus on a number which has escaped proper scrutiny:- £1.3bn.

That’s what the NHS reorganisation is going to cost, according to the government.

The figure is contained in a report whose very title seems to discourage interest: Co-ordinating document for the Impact Assessments and Equality Analysis. This gives the detail of the projected costs. It’s a classic of its type: sober, measured and with an authoritative tone.

And hopelessly wrong. The £1.3bn identified will be almost certainly just the start of the spending.

To anyone with even passing experience in managing large-scale reorganisations, the department of health’s assessment should flash more warning lights than the police switchboard on riot night.

The £1.3bn figure is made up of redundancy costs of £1bn for 17,000 staff and £300m of what the department calls “one-off transition costs…around IT and property”.

In return, the government expects to make a £1.5bn saving each year after the change is implemented, giving a net saving of £3.2bn over the course of this parliament. Impressive.

Or it would be impressive were it realistic.

Few disagree on the need for reform in public services, particularly in economic times such as these. And change, when implemented in the right way can achieve the savings needed and improve care in line with the traditions of the NHS.

But looking at the scale of what the department of health is attempting and comparing it to recent corporate reorganisations, three problems are soon apparent.

First, the savings are aggressive given the costs; second, the costs identified don’t appear to be complete; and third the timetable for achieving savings is optimistic to say the least.


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