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Sunday 18th March 2018

NHS boards' duty to the public

30th July 2008

It is crucial that what is necessary for the population is put forward in front of the health service boards’ narrow concerns. These boards should act “as servants of the community need and not its masters”.


The positions of power in the health service come from the politically motivated Department of Health and are organised in such a way that they bypass “chairs, non-executive directors and therefore the boards”.

I believe that this system acts to greatly and unavoidably compromise the way the NHS is governed.

Both the Department of Health and the health service are confused about how the system is managed. Often, you will hear high-ranking staff talk about how boards manage their business.

The way they talk suggests a basic lack of understanding about the clear division that should be present between the role of a board which is concerned with legislation and the duty of the executive, which is to be in charge of and run the organisation.

I have worked with over 100 health service bodies and I was taken aback to see the lack of “explicit attention” that was given to the fulfillment of their duties.

Unfortunately it is the case with most NHS boards that the strain of the “system tended to narrow and to distort their priorities”.

To ensure effective and authoritative governance, a board must put policies in place which show, on both an executive and local level, the key principles which support the health service.

An NHS board should demonstrate commitment to Cicero's instruction: "Let the good of the people be the highest law."

While the history of the health service shows that putting this principle in place was extremely difficult, due to the obsession with “granular” parts of the service rather than how it functioned in its entirety, things are changing.

In 2009 the pan-regulatory comprehensive area assessment will be introduced and will assist health service boards to form the key objectives to ensure the community is well looked after.


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