NHS Independence Diary

Recently, there have been numerous calls for the NHS to be managed free from day to day political interference. Here we chronicle the debate as it develops:

Re-think urged on NHS autonomy

4th June 2007

The influential health think-tank the Nuffield Trust has said that the National Health Service should be given greater independence from day-to-day political controls.

The view was outlined in proposals that it plans to discuss with Treasury officials. Some experts already believe the current arrangements are “unsustainable� with parts of the NHS becoming increasingly independent, notably with the growing number of NHS foundation trusts. But the Department of Health said further independence would only be considered if the NHS improves services and delivers major benefits for patients.

Independent board for NHS?

24th April 2007

With increasing pressure on the government to give the NHS more freedom, a group of leading academics has called for the health service to be run by an independent board, writes Nicholas Timmins in The Financial Times.

According to Mr Timmins, the group of leading clinical academics from Birmingham University's Health Services Management Centre support the idea of a National Health Service run by an independent board but answerable to the Department of Health.  They propose that the government should raise funds, set targets and hold the independent board to account but that the day-to-day running of the health service should be outside of ministers’ remit.  Instead, they propose the creation of an independent NHS board which would be responsible for deciding the best organisational structure for the NHS as well as managing the finance of the organisation, setting clinical standards and managing performance.

The academics propose that the board consist of NHS leaders and clinicians as well as patients and members of the public with existing inspectorates such as the Healthcare Commission and Monitor reporting to the health secretary.  Whitehall would retain overall control; setting a three-yearly charter and holding the power to sack members of the board if standards and/or budgets were not being met. 

The proposals come as David Nicholson, the NHS chief executive, considers the creation of an NHS management executive within the department of health which observers feel could be the first step towards an independently managed health service.  It is understood that Gordon Brown has expressed interest in the idea of an NHS board.  

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