Sir Robert Naylor, chief executive of UCLH, said the climate of political uncertainty was a major problem for the latest set of NHS reforms.
And he warned that CCGs were unlikely to be able to provide the strategic leadership that the system required.
He told a seminar at the King’s Fund in London: ‘The jury is still very much out on whether the latest commissioning arrangements will last any longer than fundholding did.’
The fundholding scheme was launched by the Conservative government in 1991 and abolished by Labour in 1998, after more than half of GP practices took the opportunity to hold their own budgets for elective care.
Sir Robert said there was bound to be another reorganisation following the next general election and that anyone who thought the current reforms would provide a ‘final fix’ was being ‘extraordinarily naïve’.
He said there would be a ‘vacuum of strategic leadership and direction’ without strategic health authorities and he did not expect CCGs to fill the gap.
‘Strategic leadership is absolutely crucial but I doubt whether GP commissioning will be cohesive enough to take a strategic view of these huge issues, particularly in our major cities.’