Intended for healthcare professionals


Milburn's vision of a new NHS

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1078
  1. Rudolf Klein (, senior associate
  1. King's Fund, London W1G 0AN

    Adopting the missionary position

    News p 1083

    Having established a reputation as the most centralising secretary of state for health in the history of the British National Health Service, Alan Milburn now seems determined to recast himself as the man who shifted the “centre of gravity within the health service from Whitehall to the NHS frontline.” This, he emphasised in a much advertised speech last week,1 is to be the theme of Labour's second term in office.

    Power and resources are increasingly to be transferred to primary care trusts, which are expected to control 75% of the NHS's budget by 2004. Clinicians are to be more involved in the design of services at all levels, starting with the Department of Health itself, as well as being given more control over budgets. NHS trusts, including primary care trusts, “will have greater operational freedom.” And to promote this “new decentralised approach,” the structure of bureaucratic control is to be simplified: responsibility for “performance managing the local health care system” …

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