MPs have launched a stinging attack on the government's "distracting" health reforms and criticised its overconfidence in the race for efficiency savings.
A report by the Health Select Committee, published today (24 January), says there is "disturbing evidence" that NHS organisations are "salami slicing" in a bid to cut costs.
Such measures, the report says, will not lead to sustainable savings nor will they allow the Nicholson Challenge to be achieved.
"We have the impression that NHS organisations are making do and squeezing savings from existing services simply to get through the first year of the programme," says the committee's report.
"We have heard little to persuade us that this overriding need to do things differently is being planned for in future years and we are convinced that the required level of efficiency gain will not be achieved without significant change in the care model."
Despite the government's confidence in achieving sustainable savings, MPs remain concerned that the "magnitude of the [financial] challenge has not been fully grasped".
"The Committee is right to stress that meeting the Nicholson Challenge is the most important priority facing the NHS, despite the headlines generated by the health reforms," said John Appleby, Chief Economist at think-tank The King's Fund.
"The report should serve as a wake-up call for ministers and the NHS about the magnitude of the task ahead. If delivering the productivity improvements required is challenging now, it will only get more difficult during a financial squeeze that is set to last several years."
In the latest blow to the government's proposed health reforms, the Committee – led by the former Health Secretary Stephen Dorrell – criticised the "reorganisation" process for "continuing to complicate" the push for efficiency gains.
"[The] disruptive reorganisation process [caused by the government's health reforms] hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings," says the report.
Dorrell told MiP while he didn't believe the Health Bill should be withdrawn, he said the reform will inevitably put the £20bn efficiency savings at risk thanks to the government failing to properly communicate and prioritise the delivery and integration of care in its plans.
"All new processes are going to create confusion and uncertainty," he said.
"But all the evidence points to this change process being behind target. There has been progress in some areas but overall, the pace of change is too slow."
MPs also noted the "masked disconnect" between the concerns expressed by those responsible for delivering services, and the "relative optimism" of the government.
"I do think the government is listening to the concerns of the medical profession but I doubt whether they are reacting," Dorrell told MiP.
Amid speculation Health Secretary Andrew Lansley will be given the boot during the Prime Minister's next cabinet reshuffle, Dorrell told GPB he is "not interested" in stepping back into his old post.