In theory the shake-up of the NHS will cost over £1bn upfront but save more than £1bn annually thereafter, according go the coalition. But there are many inside and outside the health service who fear for the consequences of such a major management revolution, as I wrote a few days ago.
Sir Nick Macpherson, permanent secretary at the Treasury, appeared to issue a coded warning over the reforms when he addressed the public accounts committee on Wednesday afternoon.
“From time to time there have been problems in other departments….with the department of health several years ago where there was a problem with their finances, it often happens at a time where you’re reforming the system,” he said.
It doesn’t seem too far-fetched to wonder whether the highly-regarded mandarin had the coalition’s imminent NHS reform in mind. I’m aware that the upper echelons of the Treasury are keen to ensure that the imminent health reforms achieve their intended savings and do not result, conversely, in unforeseen financial problems.