The King's Fund, an independent think tank has reported that the NHS needs a "clearer separation of the government from the delivery of health care" and not more money.
In a report published last week, the King's Fund said that although the NHS has had a history of underfunding and lack of capacity compared with European neighbours, finding answers to where money should come from was not the key issue for improving the NHS.
The current system, the report said, draws the government into taking responsibility "for every dropped bedpan." It calls the system "over-politicised" and "over-centralised," and recommends that the government be less involved in ensuring the delivery of policy in practice.
The report suggested that a new legislative settlement for the NHS is needed to clarify and demarcate the role of government. A new NHS Corporation, rather than the government, could take over responsibility for national guidance and regulation of the service. NHS staff themselves would then be responsible for reform through local leadership.
The government would then have a reduced responsibility and could concentrate on raising finance and setting a broad strategy for health and health care. Parliament would be responsible for holding the NHS Corporation to account.
Patient choice should also be extended, the report said, to drive up quality in the NHS. GPs should help patients to make informed choice about their care, and purchasers of care should also be responsive to the wishes of patients when commissioning care. For example, the report said that purchasing many more hospital services outside the hospital setting may better meet patients' preferences for their care.
Although the King's Fund did not think that deciding where the money for the NHS should come from was the key question, it nevertheless thought that funding through general taxation was the best way of paying for health care.
The Future of the NHS—A Framework for Debate is available at http://www.kingsfund.org.ukwww.kingsfund.org.uk