Richard Scorer explains why decisions regarding changes in the NHS are increasingly heading to the courts
The NHS is undergoing huge change. Reform is taking two main forms, privatisation and ‘reconfiguration’. Privatisation involves the contracting out of specific services to private companies eg NHS Logistics to DHL. Reconfiguration is explained in the Department of Health white paper, Our Health Our Care Our Say: a New Direction for Community Services, 30 January 2006, as a “strategic shift” in the delivery of health care with fewer patients treated in hospital and more services delivered closer to home.
Both types of reform are controversial. Privatisation is particularly contentious within the trade unions and the Labour Party. Reconfiguration is generating a significant public backlash. This is because the shift towards specialist centres and community care is resulting in the loss or downgrading of many familiar district hospital services eg accident and emergency, maternity and paediatric services.
Another aspect of the current situation is that, despite the most sustained period of funding growth ever, the NHS is in financial crisis. In 2005–06 NHS trusts in aggregate overspent by more than £1.2bn,
