Reviews Personal views

It is time to separate the NHS from direct government involvement

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7556.1518 (Published 22 June 2006) Cite this as: BMJ 2006;332:1518
  1. Layla Jader, consultant in public health medicine (Layla.Jader@nphs.wales.nhs.uk)
  1. Welsh BMA Committee of Public Health Medicine and Community Health, Cardiff

    Precious NHS resources have been wasted in constant structural changes. The government and all political parties should endorse the proposal that as part of the modernisation agenda the management of the NHS should be totally separated from direct government involvement. This can be achieved by delegating overall NHS management power to an all party elected body, which would include experts in professional, clinical, and health service management and which would be advised by an accountable body (see figures).

    Such an independent management body would bring balanced political and electoral representation to the NHS as well as the expertise of highly experienced health professionals elected to represent the NHS staff from within their clinical, professional, and health service management organisations. It would be better placed to deal with the difficult issues of prioritisation and future funding of the NHS and would oversee policy, planning, performance management, and quality assurance.

    As BMJ editor Fiona Godlee has said (Editor's choice, 1 April 2006), the NHS needs a system that replaces political dogma with clinically driven decisions, confrontation with consensus, unaccountability with democracy, and short term decision making with long term stability. The NHS is too complex and too vital to our future …

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