The argument for an independent National Health Service has shifted up a gear after it was revealed that seven out of ten people think that politicians should bow out of the day-to-day running of the Service, according to research by Ipsos MORI commissioned by the NHS Confederation.
A separate survey of NHS chiefs found that the majority (91%) agree or strongly agree that locally-made decisions ultimately lead to better outcomes for patients. But when asked to consider the best ways of attaining this, just 7.8% were in favour of an independent board, while the largest proportion (44.3%) were behind modifying performance management and regulation to give more of a focus on the patient instead.
The findings coincide with publication of the NHS Confederation’s From the ground up: how autonomy could deliver a better NHS report, which supports transferring autonomy and boosting accountability within the Service but believes that behavioural change, as opposed to yet more restructuring, is the way forward.
“An independent board may be part of the answer, but would not be enough to deliver a truly patient-led service unless it goes hand–in-hand with real devolution of decision-making closer to patients,” the Confederation said, stressing that the current issues the Service has are not just down to political interference.
Political involvement 'unavoidable'
“NHS leaders and the public’s views seem to converge on the best level of decision-making in the NHS,” commented Dr Gill Morgan, chief executive of the NHS Confederation. “We now need to make this happen,” she said, but added that, while an independent board might be part of the solution, “some form of political involvement is unavoidable in a service that spends over £100 billion of public money.”
Support for an independent NHS is certainly growing. In May, the British Medical Association unveiled its discussion paper A rational way forward for the NHS in England, which outlined an alternative approach to reform that would separate national politics from the daily running of the Service. And this was followed by the publication, earlier this month, by a report from The Nuffield Trust, which also called for the government to hand over the reigns.
At the time of the launch of the BMA’s report, James Johnson, former chairman of the Association, said: "The government's injection of funds has led to considerable improvements but there has been a failure to engage either the public or clinicians in the government's reform agenda. That reform is destabilising the NHS and the system of care is becoming fragmented."
But last week Health Secretary Patricia Hewitt rejected the notion during a speech to the London School of Economics, saying that the proposal would turn the Service into a "1960s nationalised industry," according to media reports.
"If the NHS was a country, it would be the 33rd biggest economy in the world, larger than new European Union transition economies like Romania and Bulgaria. Would the Prime Minister of such a nation seriously propose today to take the entire economy and put it under a single independent board, every organisation in the hands of one owner, run as one entity? Of course not," she reportedly argued.