Medicopolitical digest

Health secretary rejects royal commission on the NHS

The health secretary, Mrs Virginia Bottomley, has rejected the call from the National Consumer Council for a royal commission on the NHS. The minister said that “thanks to the health reforms, power in the new health service has been shifted towards patients and their advocates. The patient's charter is building on this, making the NHS more user friendly and responsive.”

The approach in Britain, the health secretary says, “is based firmly on local priority setting within a coherent national policy framework.” In a letter to the council Mrs Bottomley said that Britain was also leading the field in improving the knowledge base of the NHS. No other country was doing as much to establish mechanisms for evaluating what worked and what did not.

The minister quoted the editorial in the BMJ which described five key driving forces transforming the face of medicine (20 October, p 1099). Four of them, she said, were directly relevant to the current debate: the power of health purchasers, the rise of the informed patient, the impact of new technology, and a shift of boundaries between health and medicine.