BMJ  2007;335:61 (14 July), doi:10.1136/bmj.39269.588738.DB

News

Government's plan for NHS review gets mixed response

London

The UK government has announced a review of the NHS in a bid to ensure that clinical priorities and local accountability are paramount in the health service's day to day operations.

The health secretary, Alan Johnson, has asked the junior health minister and surgeon Sir Ara Darzi to lead the review and to consult widely with patients and staff.

The move is widely seen as a bid to mend relationships with health professionals, many of whom feel aggrieved by a decade of non-stop NHS reforms.

Mr Johnson said that providing more accessible and convenient care for patients; achieving better value for money; and ensuring that people with long term illness were "treated with dignity in safe, clean environments" were all key areas that the review would look at.

He also announced an extra £50m ($100m; 74m) to fight hospital acquired infections.

Mr Johnson said, "The past 10 years have seen huge improvements in the NHS, and thanks to record investment and measures to raise standards, nine out of 10 patients rate their care as good to excellent."

But he added, "What was right for the last decade—top down targets and important but sometimes difficult reforms—will not be right for the next, where more local decision making and staff empowerment need to drive the NHS."

He said that the review could result in an NHS constitution that sets out its values and lines of accountability.

The full report will be published in June 2008. An interim assessment in autumn 2007 will inform the next comprehensive spending review.

Gill Morgan, chief executive of the NHS Confederation, said, "We hope that this is not just another review but a genuine exercise in listening and understanding where the service has got to and where it needs to go. The opportunity to re-engage staff with the NHS reform programme is too important to be missed."

She added, "We welcome the exploration of an NHS constitution to enshrine the values and principles of the NHS, but for an organisation the size of the NHS this will obviously be a huge task."

Hamish Meldrum, chairman of the BMA, was less enthusiastic about the review, however. He said, "It is disappointing that the government feels it needs to undertake a review when the problems of the NHS have been apparent to the BMA and others for many months."

The Liberal Democrats' health spokesman, Norman Lamb MP, said that the review "failed to address some of the central failings in the NHS.

"It is silent on the damaging health inequalities that have widened under Labour. It also says nothing about the democratic deficit in the NHS, which has seen people across the country have little say in whether their local hospitals get shut down.

"And there is no mention of how productivity in the NHS has decreased, despite government spending having trebled."

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