• Lord Prior says NHS too big, centralised and hierarchical to manage
  • Cultural barriers to innovation in the NHS
  • ULCH chair says trust won’t meet efficiency target next year

Former health minister Lord David Prior has said the NHS is too big and centralised, and even God “would struggle” to manage it.

Speaking at an Institute for Public Policy Research event about innovation in Westminster, Lord Prior, who is also a former Care Quality Commission chair, said the NHS was too hierarchical, “too political” and short term in its thinking.

“We have created something that is almost impossible to manage. Even if God was to run the NHS he would struggle,” he said.

Local NHS organisations were risk adverse and relied on regulators for guidance, he added.

”We’ve tried regulation…regulation works to a point but it can, if we are not careful, leave you with a compliance culture.”

These cultural barriers made it difficult for the NHS to be on the “cutting edge of technology,” he said.

”It’s so difficult to make things happen in the NHS that people give up.”

The peer was a junior health minister from May to December 2016.

In October last year, he was appointed chair of University College London Hospitals Foundation Trust.

He said that while his trust had more financial headroom than most to innovate it would still not make its efficiency target for next year.

”At ULCH we have to make 6.7 per cent improvement in our costs next year. We won’t do it….it’s very hard to do 2 per cent on an ongoing basis.”

That financial pressure on trusts left “very little” bandwidth for innovation, he said at the event on Wednesday.