Published 22 July 2008, doi:10.1136/bmj.a497
Cite this as: BMJ 2008;337:a497

Analysis

Operational independence for the NHS

Rhema Vaithianathan, Harkness fellow1, Geraint Lewis, Harkness fellow2

1 Harvard Medical School, 2 New York University

Correspondence to: R Vaithianathan vaithianathan@hcp.med.harvard.edu

Ara Darzi didn’t suggest freedom from government control in his review of the English NHS, but it might sound attractive to many health workers. Rhema Vaithianathan and Geraint Lewis show how it could work using the theoretical framework of independent central banks

The first 150 words of the full text of this article appear below.

The long term interests of the National Health Service are often undermined by its political governance structure.1 2 Health ministers are diverted by the exigencies of a short electoral cycle and by the perception of personal responsibility for all failings. This has compelled them to interfere with health technology recommendations, to reorganise the NHS repeatedly, and to interject on transient, local issues.2

In the late 20th century, monetary policy likewise suffered from unhelpful ministerial interventions. The concept of an independent central bank arose from the belief that an independent agency would promote a politically neutral, long term approach.3 In 1997, the Bank of England was given operational independence from ministers, and it has since been highly effective in maintaining price stability. This has led several commentators to call for the NHS to be given operational independence,1 2 4 which would preserve its founding principles (free health care for all with revenue generated through . . . [Full text of this article]


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Too Many Chefs........
Jay Ilangaratne
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Free the NHS from political meddling
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