Under the coalition government we are seeing proposals and ideas which will impact upon the delivery of healthcare in the UK to a level which we have never seen previously. The reforms proposed by the Government will radically change healthcare delivery for ever.

Previously we have had a very layered system with the Key Trusts, Primary Care Trust and GP’s. At times this has been a cumbersome structure but services have been delivered across communities with an increasing emphasis on integration.

At _space we delivered a considerable community hospital project in Redcar and Cleveland which brought together a number of GP practices and community care facilities and wards under one roof. The facilities themselves were second to none but only time will tell if this concept has been successful and is providing value to the community it serves.

It has also been much maligned lift project which has developed a number of joint ventures between the public and private sector to deliver primary health care services. Certainly in some areas this has been very successful and others less so.

Moving to the future it seems that the plan is to simplify this structure and ultimately work with Key Trusts and GP’s with a very light touch from central Government.

We are already seeing some GP’s offering private services themselves or encouraging patients to use other health care providers rather than the NHS.

We will see a polarisation of the market with the private sector identifying potential opportunities and investment as the model becomes defined. It is likely that the private sector will identify routine operations and services which can be delivered efficiently and affordably. I anticipate procedures such as cataract operations or in growing toenails for example will be delivered cheaply by specialist private health care providers. They will also be able to provide higher quality standards in relation to services such as on-suite bedrooms that will drive efficiency out of the process.

The acute hospitals will be left to pick up the more complex functions which carry greater overhead and expertise. We will also continue with research and development function traditionally attributed to the NHS.

The challenge will be a lack of investment to continually strive for better services. Many of them are also left with large estates which may be oversized for their new operation. Existing hospitals will have to react quickly to a change in the market place and reduce their overheads and focus their services on the specialist requirements rather than trying to compete with the private sector who will be well funded with little package from the past.

The next few years will be very interesting to see how the sector responds and how much interest there is from the private sector.