NHS royal commission should assess long-term future, says Lord Saatchi

A royal commission should be set up to examine the long-term future of the National Health Service, a senior Tory peer has said.

Former Conservative chairman Lord Saatchi said a commission could take the issue out of politics and “detoxify” any changes that needed to be made.

His recommendation comes before the publication of a report that is expected to show the parlous state of English NHS finances.

In a paper for the Centre for Policy Studies thinktank, Lord Saatchi said: “There is a wide range of perspectives on the current performance of the NHS, and varied confidence in its long-term future, from the pessimistic view that the system is in crisis, to the optimistic position that its only threats are meddling politicians. A royal commission offers significant benefits regardless of the position taken.

“A royal commission is an opportunity to help reverse a deterioration in some clinical outcomes, to identify and eliminate barriers to equal access, and to ensure that trusts are adequately funded to cope with current demand pressures. The solutions it arrives at could help to avert the kind of distress seen throughout the system over the 2016-17 winter.”

Saatchi said the advantages of a commission, rather than any other sort of inquiry, included “the ability to secure the bipartisan support needed to embed lasting changes, to detoxify reforms that otherwise may be too politically dangerous to pursue, and to deploy its unique investigatory power to establish what reforms are needed to ensure that we have a world-class, 21st century, health system”.

“A commission’s investigatory powers and capacity to provide evidenced-based review, free from the constraints of the immediate political cycle, allow it to craft solutions that command the support of practitioners and politicians alike. When set up properly, its recommendations carry a unique legitimacy that could be essential to securing a lasting, bipartisan settlement on the NHS.

As the NHS approaches its 70th birthday he said it “would be reckless not to seek a full body check-up – the first in decades”.

On Monday, NHS Improvement’s figures for the third quarter of 2016-17 will be published.

NHS Improvement’s chief executive, Jim Mackey, has acknowledged that trusts would miss the £580m deficit “control target” and forecasters have predicted the combined hole in their finances could reach nearly £1bn by the end of the year.

Responses to the King’s Fund thinktank’s latest survey of NHS finance directors, carried out in late January and early February, made for “uncomfortable reading”, its director of policy, Richard Murray, said.

“They suggests that the forecast net deficit has risen by about 30% since the autumn, when NHS Improvement’s quarter two report showed a net deficit for the year of £669m. Simply applying one number to the other would give a 2016-17 net provider deficit somewhere between the £820m to £920m mark.”

Murray suggested it was a “big ask” to expect trusts to recover ground over the remainder of the year, given the scale of the winter crisis.

NHS royal commission should assess long-term future, says Lord Saatchi