INSPECTION Commissions overhauled after less than 12 months

Published: 24/03/2005, Volume II5, No. 5947 Page 6

Plans to merge the Healthcare Commission with the Commission for Social Care Inspection could waste two years of management time, experts have warned.

Concern is widespread over chancellor Gordon Brown's announcement last week that the health and social care inspectorates - both less than 12 months old - are to be merged. Both bodies have warned that moves towards merger by 2008 are likely to cause disruption.

King's Fund chief executive Niall Dickson mirrored their fears, claiming the planned merger was 'bound to cause consternation'.

'Chopping and changing organisations like this is an expensive and disruptive business and doesn't smack of sensible policy-making, ' he said.

'Reorganisations remain a clumsy reform tool that tend to produce a drop in performance.

It takes a new organisation at least two to three years to start to perform as well as its predecessor.'

Dr Naomi Fulop, senior lecturer at the London School of Hygiene and Tropical Medicine, conducted an influential study in 2002 that found service development was put back at least 18 months by trust mergers.

She said the merger of the inspectorates was likely to have a similar impact. 'It is a constant strain on the NHS that they never let organisations establish themselves before they reorganise them.' Dr Fulop said the announcement would have an impact on the morale of staff who would be concerned about their jobs. 'The lessons from our work is that mergers require very careful managing or the disruption gets out of hand, ' she added.

Healthcare Commission chief executive Anna Walker said the merger was a natural step as the barriers between health and social care had been evaporating for some time. But she said it was vital that the commission got the chance to see through its reform programme.

'Structural change must not hamper the real improvements in services that we are driving for patients, the public, doctors and nurses, ' said Ms Walker.

Association of Directors of Social Services president Tony Hunter said he regretted the 'renewed turmoil that risks affecting social care delivery' following the announcement.

'Presenting the arrangements as part of the budget announcements rather than as a basis for improvement has raised understandable concerns, ' Mr Hunter added.

CSCI chair Dame Denise Platt said the instability caused by any merger would mean it would have to modify plans for modernising social care regulation.