The "dismantling" of the current management controls could see CCGs going bust or cutting services under the government's health reforms, a leaked draft risk register has revealed.
Calls for the government to release its transitional risk register are growing ever louder as health writer Roy Lilley leaked a draft version of the much sought after document on Twitter yesterday (26 March).
The Information Tribunal ordered the release of the risk register on the 9 March following a government appeal.
A spokesperson from the Information Tribunal office told MiP a detailed explanation of the judge's decision requested by Health Secretary Andrew Lansley is "likely" to be published early next week.
The document warns the health system could become "more costly" if CCGs chose to make use of private sector organisations.
Financial control could also be lost if the Health and Social Care Bill becomes law, thanks to the restructuring of budgets distributed between or allocated to organisations within the system.
The draft risk register also casts doubt over the capability of GP leaders in running CCGs – it claims they may be drawn into managerial processes which drive clinical behaviour, rather than the preferred other way round.
It warns CCGs could face having to cut services, or even going bust through the "dismantling of the current management structures and controls".
Practice engagement in CCGs is also deemed a 'longer term' risk, with the document warning they may be unable to negotiate the necessary changes to the GP contract to "incentivise and lock" practices into the new commissioning organisations.
A spokesperson from the Department of Health insisted the government has always been "open" about the possible risks that could arise from its reforms.
"We do not comment on leaks," they said.
"We have always been open about risk and have published all relevant information in the Impact Assessments alongside the Bill.
"As the latest performance figures show we are dealing with those risks, performance is improving - waiting times are down and mixed sex wards are at an all time low - and we are on course to make the efficiency savings that the NHS needs to safeguard it for the future."