Published: 30/09/2004, Volume II4, No. 5925 Page 8

The merger of the Health Development Agency with the National Institute for Clinical Excellence next year poses 'significant risks', Treasury adviser Derek Wanless warned this week.

He told the final HDA conference in central London last week: 'There is inevitably some disruption with this kind of merger and it is clear that this could endanger some of the work that NICE is doing. And also, much of the HDA's work is more difficult, involving as it does a lot that is outside the NHS.'

It would be a challenge for the new organisation not merely to continue current performance, 'but to fill the gap that exists in public health evidence'.

Mr Wanless said his second report, published in February, would act as a benchmark to judge the government public health white paper, expected next month.

He also predicted that measuring NHS productivity would be 'a big and controversial issue in the next election' and the NHS had put itself in a 'terrible position' in the past by measuring the wrong things in too crude a way.

He said work being done by the Office of Health Economics to create more sophisticated measures better able to assess the value of preventative measures 'will I think show that the NHS is much more productive than has previously been shown'.

Later in the conference, HDA chief executive Paul Streets said the merger would succeed 'if it [NICE] takes on board what we have learned about implementation and making the case'.