UK chancellor proposes independent board to run NHS

An independent board responsible for the day to day running of the health service has been proposed by the UK's chancellor of the exchequer, Gordon Brown, as a way of defusing political disputes over its performance.

Figure 1.

Gordon Brown said it was necessary to separate the decisions that politicians make from day to day administration of the NHS

Credit: JOHN THOMPSON/MOUSETRAP MEDIA LIMITED

The idea, to “depoliticise” the NHS, is being compared to the government's decision to hand responsibility for interest rates to the Bank of England. It is being widely discussed by NHS leaders because of the strong possibility that Mr Brown will succeed Tony Blair as the United Kingdom's next prime minister.

Mr Brown, addressing this week's Labour party conference in Manchester, said, “The purpose of independence for the Bank of England was to devolve power and separate the making of public policy from the independent administration of daily business.

“And I believe we must now examine how elsewhere we can separate the decisions that, in a democracy, elected politicians must make from the business of day to day administration.”

Mr Brown is understood to have asked experts to explore the possibility of an independent board to run the NHS, with health ministers setting only the budget and strategic objectives.

Doctors' leaders are sceptical, and the BMA's chairman, James Johnson, said, “The controversial aspect of the health service at the moment is the strategic direction, not the detail. If you hand the detail over to somebody else but leave the strategy with politicians, it will do nothing to remove the current criticisms of the direction in which the government is taking the NHS. It is the strategy which needs to be at arm's length.”

Mr Brown's idea is similar to a plan, due to be announced at the conference, to create a constitution for the NHS similar to the BBC charter.

The health minister Andy Burnham, writing on the website of Progress, the independent organisation for Labour party members, said that there should be fewer targets, local decision making, and more operational independence for the NHS.