- Health ministers should stick to policy work and leave implementation to
an arms-length NHS agency, a King's Fund report says today. Helene
Mulholland
Tuesday October 28, 2003
- The NHS should become an independent body similar to the BBC to prevent
further financial crisis, the editor of the British Medical Journal (BMJ) said
today. In an editorial, Fiona Godlee contends that independence from the
government would prevent the NHS from being undermined by short-term planning
for political gain. David Batty
Friday
March 31, 2006
- Tory proposal
for independent NHS board stirs lively debate. The Conservative party has
formerly unveiled its plans for the NHS, attracting faint praise from health
minister Rosie Winterton who said the proposals were "worth looking at".
However experts have questioned the notion of an independent NHS board to
commission services as creating a double negotiation, first between ministers
and the board and then between ministers and the treasury, potentially making
funds harder to secure. Plans to set free NHS foundation trusts from Treasury
controls were also questioned as, without privatisation, the question of who
picks up the bill for failed trusts looms large. The shadow health secretary
Andrew Lansley wants NHS foundation trusts free to borrow without Treasury
controls. But banks are unlikely to lend significant capital sums without
security over assets such as hospital buildings. "We would have to have a
failure regime capable of securing the assets needed for the NHS to maintain
provision," he said. Lenders might still lose money but the NHS might also
have to provide some compensation to take the assets over. That, however, goes
back to the fundamental argument mounted by Gordon Brown, the chancellor, when
foundation trusts were first mooted in 2000. He insisted that if foundation
trusts were set free to borrow, but with the Treasury responsible for picking
up the bill if they ran into trouble, the borrowing must remain subject to
Treasury control. The planned independence drew further questions over
accountability with Liberal Democrat health spokesperson Steve Webb saying:
"We should not be handing over power to an unelected quango - independent of
politicians, but accountable to no one." Professor Chris Ham, former head of
strategy at the health department, expressed the seemingly common concern of
"How do you draw a real distinction between strategic issues…and the
operational matters. If that contract cannot be clearly drawn, it is a recipe
for muddle and confusion." David Hunter, professor of health management at
Durham University criticised comparisons between the health service and the
BBC or Bank of England saying: "The NHS is about life and death and health,
and it is naïve to assume that politicians can withdraw." John Appleby, senior
economist at the King's Fund health thinktank, said that there was widespread
agreement that ministers should be less involved in day-to-day running of the
NHS but questioned whether structural change could achieve that and asked "why
don't politicians just change their behaviour
?" Summary by
Keep our NHS Public of Financial
Times 10 October 2006
- Take politics
out of day-to-day NHS management, urge doctors. The British Medical
Association has called for independent management of the NHS and a more
explicit means of rationing care. The proposals, contained in what the BMA
described as a "green" paper for debate, challenge both Labour and
Conservative policy for the NHS and the BMA has said it wants to move away
from the "purchaser/ provider"
division that is a central part of both parties' policies. Private provision
should only be used where there was no NHS capacity in order to support
rather than supplant the service and there should be "no further central
procurement of private sector provision," said the association. The BMA
wants an independent board of governors to run the NHS and an executive
board to handle day-to-day demands. James Johnson, the BMA's chairman of
council, said: "We need a public debate to decide a process to define a list
of core NHS services - it will be a very substantial core - that will be
available nationally," with the NHS able to top that up locally where money
was available. He added that rationing already occurred within the NHS but
it needed a "clear and transparent approach" rather than the "piecemeal
fashion" it was currently implemented in. The BMA declined to define what
these services would be. It recently emerged that the Department of Health
was examining drawing up a list of "a package of services that all users are
entitled to", however Andy Burnham, the health minister, said yesterday that
it would resist any attempt to slim down the NHS. Andrew Lansley, the
Conservative health spokesperson, said the BMA were taking a "pessimistic
rather than optimistic" attitude to the future of the NHS.
Summary by
Keep our NHS Public of Financial
Times 9 May 2007
- Health thinktank puts forward blueprint for NHS independence.A blueprint for giving the NHS independence from government control was
published yesterday in an attempt to influence Gordon Brown's health
policies when he takes over as prime minister next month. The Nuffield
Trust, a health thinktank, said operational control of hospitals and primary
care should be passed to an independent corporation, similar to the BBC,
operating under a charter that guaranteed a free service to patients.
John Carvel, social affairs editor
Friday June 1, 2007 The Guardian
-
An Independent NHS- A review of the options. The Nuffield Trust commissioned
an examination
An
Independent NHS- A review of the options of the options for independent
management of the NHS as a contribution to the current debate about the
future of the NHS.
Care & Health 8 June 2007
- The public support doctors' plans for the NHS, says BMA. There is
widespread support among the general public for key aspects of the BMAs
rational way forward for the NHS in England, including the BMAs call for an
independent board to run the NHS.
Care & Health
27 June 2007
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