Last month Ara Darzi’s landmark diagnosis of the NHS blamed misjudged fiddling with NHS structures, headquarters, and regulatory functions for helping to plunge the health service into its current parlous state.1 No one would want to go down that route again, right?
Wrong. A week later, the right wing Policy Exchange think tank is calling for NHS England to be abolished as an independent commissioning body and for its key functions to be delivered by an NHS management board within the Department of Health and Social Care (DHSC). Former Tory health secretary and now shadow chancellor Jeremy Hunt is in favour. NHS England is not.2
Sounds provocative, what’s the point?
The report says that shrinking central bureaucracy should be part of a great “rebalancing”—some functions could be overseen and held more tightly by ministers and others more loosely, with greater autonomy for managers and clinicians throughout the NHS. The crux is a major overhaul of NHS management “capability, training, and incentives” to improve operational performance and productivity across the whole health system, with more effective procedures to dismiss managers who persistently underperform.
Who or what is Policy Exchange?
A “highly opaque” think tank with close ties to the Labour …
