Sir David said that politically driven changes to any public sector body usually ends in disaster.
Speaking to doctors at the Royal College of General Practitioners conference, Nicholson said that “carpet bombing” the health service with private sector competition was not the right way to tackle rising costs.
The NHS’ leader said that the reforms would benefit patients by offering them increased choice and improved standards of care through competition. But he added that GPs would only benefit from the reforms if they are free from negotiating new services.
“If we are creating a system where general practitioners feel it is their job to do all that, then I think we have a massive problem,” he told delegates. “We need to create the right kind of people with the right kind of skills, which we are trying to do at the moment through commissioning support, to enable people to focus their attention on clinical decision-making.
“My advice to anyone – and I have been involved in the last five or six years with the national programme for IT, and I have, as they say, the scars on the back around all of that – is that big, high-profile, politically driven objectives and changes like this almost always end in misery and failure.”
Shadow Health Secretary Andy Burnham said Nicholson’s comments were a concern. “David Nicholson is a man who has the NHS at heart, so it is worrying to hear him talk in these terms,” he said. “He has put on a brave face in public, but clearly has private concerns about the real damage this reorganisation is doing.
“His open acknowledgment of the possibility of it ending in failure will send shock waves through the NHS and provide a stark illustration of the sheer scale of the gamble the Government is taking.”