Intended for healthcare professionals

Observations Body Politic

Does NHS England have a slow puncture?

BMJ 2013; 347 doi: (Published 01 October 2013) Cite this as: BMJ 2013;347:f5812
  1. Nigel Hawkes, freelance journalist
  1. 1London
  1. nigel.hawkes1{at}

So much for decentralisation: England’s health secretary can’t keep his hands off the NHS

It hasn’t taken long for former health secretary Andrew Lansley’s plan for a “hands-off” NHS to hit the rocks. His successor, Jeremy Hunt, is behaving as if the Health and Social Care Act 2012, with its careful separation of powers, had never passed into law. If there’s a problem—and there are plenty—it isn’t long before Hunt comes up with a new wheeze for dealing with it, as health secretaries always have.

From pressure on emergency care to hospital quality or the supposed iniquities of the general practitioner contract, he’s there with an opinion and an initiative. His junior minister, Dan Poulter, has echoed his master’s voice with a plan of his own, suggesting with no great originality that the NHS could save money by better procurement.1

The merits of these interventions matter less than their frequency and specificity, which tell us that the Lansley plan is in tatters. Liberating the NHS, the July 2010 white paper that set out the plan, said that the aim was to give the NHS greater freedoms and to prevent political micromanagement. The NHS Commissioning Board (now NHS …

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