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Set providers free

22nd March 2007

The NHS is unconventional, writes Richard Bourne, chair of Essex Rivers Healthcare Trust, and is more a collective of vested interests than a single organisation.

regulating healthcare

He writes in the Health Service Journal, that the NHS faces a continual and often incoherent barrage of advice, instructions and demands which can change almost daily, and accountability is muddled by different layers of management.

‘The NHS is managed badly. It has neither the capability nor capacity for the efficient management of so many component sub-organisations, especially during a period of change. Some would add it does not have the right culture either.’ He writes.

To create a genuinely world class NHS, he calls for a radical and brave approach: split commissioners from providers and allow providers to be completely autonomous to make changes free of scrutiny; reduce the number of organisations by getting rid of primary care trusts, strategic health authorities, overview and scrutiny committees and use unitary authorities for commissioning.

‘There is far more chance of autonomous, business-driven foundation trusts agreeing to collaborate than there ever was from NHS bodies who were actually supposed to co-operate,’ he concludes.

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