BMJ Editor calls for independence for the NHS

Editor's Choice: Time to leave home; BMJ Volume 332

In this week's BMJ, Editor Fiona Godlee calls for independence for the NHS.

These are bad times for the NHS, she writes. The words "crisis" and "meltdown" are flying around and few people say these are exaggerations. Record spending has delivered record deficits and uncertain value for money. For the first time in anyone's memory, sizeable numbers of NHS staff are losing their jobs. How has this happened and what's to be done?

Last week's edition of the BBC's Panorama roundly blamed the government. But government ministers blame managers. On Panorama health secretary Patricia Hewitt spoke of "a few bad apples" - incompetent managers who have failed to balance their books - and a culture of overspending. The managers interviewed on the programme cried foul. They said they had done what the government asked.

"If this crisis tells us anything it is that health care is too important to be left to politicians," she writes. "If the NHS is to stop being a political football kicked from one party's version of an internal market to another's, it needs to be protected from party politics."

"An independent NHS authority (or four authorities for England, Scotland, Wales, and Northern Ireland) could do this. Each would be run by a board of governors responsible for managing health care within a set budget and a broad political framework. The analogy to that other great British institution, the BBC, is obvious."

"Gordon Brown's first act as chancellor was to give the Bank of England independence to set interest rates. His first act as prime minister should be to give independence to the NHS," she concludes.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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