Headlines: October 28th, 2003

There is a new call for legislation to set up a new body that could lead to the National Health Service agreeing realistic improvement targets and taking responsibility for delivering them. In a report published today, the King’s Fund says the government would then be able to focus on developing wider health policy instead of meddling in health care services on a day-today basis.The report urges a new, more mature relationship between government and the health service. This, it says, would involve a more transparent and inclusive approach to setting expectations for national policy, and would enable greater ownership by NHS staff of targets for improvement. It would also enable Parliament to play a greater role in holding both government and the NHS to account for their respective responsibilities.

The study, “Government and the NHS: Time for a new relationship?” has been written by King’s Fund health policy director Steve Dewar. “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,” he says.

The fund’s chief executive, Rabbi Julia Neuberger, pointed out that a wide range of public services, including higher education, housing associations and broadcasting, were now either funded, delivered, or regulated through agencies working at arm’s length from government and it was time for a similar model to be considered for the NHS. She said it wasn’t a question of creating an old-style public corporation to take over the delivery of health care, but an organisation to take responsibility for the implementation of national policy and national targets across an increasingly diverse system.

Under the King’s Fund proposals, the NHS agency would take responsibility for seven main functions, including allocating funds to the NHS and delivering national targets and standards for the service. The proposals would require ministers to put objectives for the agency’s work, including targets and standards for the health service, before Parliament. The agency, in turn, would have a requirement to report to Parliament at least annually and to be subject to regular review by a Parliamentary select committee. Parliament would also hold the chief executive to account, and would work towards integrating regular scrutiny of the NHS with Parliamentary debate.