A new agency should be set up to take over the government's role of setting targets and allocating funds in the NHS, leaving politicians free to concentrate on the bigger issues that have an impact on health, such as poverty, food, and housing, says a health think tank.
Steve Dewar, the health policy director at the King's Fund—an independent health charity—argues in a report that the current relationship between the NHS and government is too close. It encourages government to "meddle in" the day to day running of the health service instead of focusing on wider health policies.
Legislating for a new body to take the responsibility for setting and achieving improvement targets away from government would also benefit health authorities and NHS staff, he says. The relationship between the NHS and government would be more mature as there would be greater ownership of targets among staff as they would take part in setting them. Additionally, parliament would have greater ability to hold both the government and the NHS to account for their responsibilities.
"Far from taking politicians out of health care, this report shows how an arm's length relationship between government and the NHS, with the setting up of an NHS agency, could actually put government, politicians, and particularly parliament, in their rightful and authoritative place," said Mr Dewar.
Rabbi Julia Neuberger, the King's Fund's chief executive, described the new proposals as the "logical next step" from reforms that have already seen the responsibility for much of the funding, regulation and delivery of public services go to local bodies.
"A wide range of public services, including higher education, housing associations, and broadcasting, are now either funded, delivered, or regulated through agencies working at arm's length from government. It is time for a similar model to be considered for the NHS.
"This is not about creating an old-style public corporation to take over the delivery of health care, but rather an organisation to take responsibility for the implementation of national policy and national targets across an increasingly diverse healthcare system," she said.
"This new relationship would enable health service managers and professionals to get on with the job of delivering care as they see fit, within an agreed, broad policy framework. Government would be liberated from a narrow focus on the day to day issues in health care and move towards a concern about the impact of poverty, environment, food, housing, and education on health."
The report, Government and the NHS: Time for a New Relationship, By Steve Dewar, can be seen at www.kingsfund.org.uk/publications