Intended for healthcare professionals

Rapid response to:

Analysis And Comment Health policy

An independent NHS?

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:251

Rapid Response:

The key word in the term National Health Service is Service


Thank you for publishing this collection of views.

May I suggest that the next step is to publish outline proposals for
alternative structures and the rationale behind each.

The central thrust needs to be the effective delivery of service and
that requires explicit limits and coherent collaborative networks,
precludes complexity and obviates the involvment of commercial elements.

My own vision is of service control mechanisms composed (top to
bottom) of three interdependent co-equal elements: users,
clinicians/workforce and managers/politicians. A central broad policy
making unit (this is the Independent NHS authority, not the DoH) and
county-based implimentation units having wide discretion to take account
of local circumstances and with the requirement to co-ordinate with
adjacent areas for the equitable and geographically sensible provision of

The remit would be inclusive - primary, secondary and associated
services as a coherent whole.

No market. No pricing. Evidence based policy with monitored
implimentation of novelties in test areas etc etc.

We aspire to deliver a service, not to be corrupted by half-baked
notions of market forces.

Steven Ford

Competing interests:
I support the separation of NHS from immediate political interference.

Competing interests: No competing interests

06 August 2006
Steven Ford
Haydon & Allen Valleys Medical Practice. NE47 6LA