The next chief executive of NHS England

NHS England’s role as the body responsible for overseeing the commissioning of health services has been brought to a head by concern about the failure to achieve the target of 95% of patients attending emergency departments being seen within four hours. In response, Jeremy Hunt, the health secretary, has asked NHS England to take the lead in coordinating the production of local plans to bring emergency department performance back into line with the four hour target. NHS England will work closely with the regulator of foundation trusts, Monitor, and the NHS Trust Development Authority, but it is now undoubtedly seen by ministers as first among equals in this process.

The health secretary’s decision that NHS England should act on his behalf in responding to performance challenges is a matter of more than academic interest. His predecessor, Andrew Lansley, legislated to distance himself from detailed involvement in operational matters by restricting the health secretary’s powers in the Health and Social Care Act 2012. The theory was that ministers would set the broad direction for the NHS in the mandate issued to NHS England, thereby avoiding the risk of micromanagement of the NHS in the manner perfected by former health secretaries.

Hunt’s …