"Arm's length" NHS bodies to be abolished in spending cull
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《英国医生杂志》
In a raft of changes to various health-related government quangos, 18 so called "arm抯 length" NHS bodies are to be either reconfigured or completely abolished in a government attempt, pre-next year抯 expected general election, to save at least ?00 million ($920m; �760m).
Among those to be abolished are the Commission for Patient and Public Involvement in Health, the National Blood Authority, NHS Estates, the Modernisation Agency and the Health Development Agency.
Other changes include the abolition of both the Public Health Laboratory Service and the National Radiological Protection Board, whose roles will be assumed by the Health Protection Agency. The work of the NHS Modernisation Agency, which has been at the forefront of the current government抯 reforms of the NHS, is to be subsumed by various parts of the NHS.
The move comes after a Department of Health review of the work of its 42 health agency quangos, four of which have already disappeared.
Announcing the proposals, John Reid said: "The arm抯 length body sector has done a lot of good work, but it has grown over several decades and no longer meets current health and social care needs or those of future generations."
In October the department will set out the time frame for the changes, including plans to cut the 22000 staff working in these agencies by 25% by 2008.
The abolition of the Commission for Patient and Public Involvement proved most controversial, although its network of patients?forums will remain. Established in January 2003, the commission is responsible for the local patient and public involvement forums, which formally replaced community health councils last December.
Harry Cayton, the government抯 director for patients and the public, said that the government remains committed to an NHS that is centred on patients. "I look forward to seeing the savings and the reduction in bureaucracy arising from the changes being translated into benefits for patients and frontline staff," he said.
But the commission抯 chairwoman, Sharon Grant, felt that the proposals "will be seen as betraying the government抯 promises to provide an independent voice for patients and the public in health." The Consumers?Association also criticised the decision, saying that it contradicted the government抯 stated aim of promoting patients?choice.
Laura McMurtrie, the commission抯 chief executive, said that the review had failed to recognise "the excellent work that has been done in setting up the network from scratch." The agency will push for a formal consultation process on the proposals, she said.
Malcolm Alexander, former director of the Association of Community Health Councils in England and Wales, felt that the government realised that it had "really messed things up badly," adding that although the commission was meant to replace health councils, "instead all we have seen is inexperienced central leadership, no public offices, no staff, poor support, and no money." A new democratic model was needed, he said. Responsibility for reviewing patients?complaints that have not been sorted out at a local level has been taken over by the Healthcare Commission.
Niall Dickson, chief executive of the health policy think tank the King抯 Fund, supported the move: "Too often the government抯 solution to every problem has been to establish an agency, with the result that the NHS has been drowning in an alphabet soup of acronyms. Let us hope this is the start of a more rational approach."(BMJ Karen H閎ert)
Among those to be abolished are the Commission for Patient and Public Involvement in Health, the National Blood Authority, NHS Estates, the Modernisation Agency and the Health Development Agency.
Other changes include the abolition of both the Public Health Laboratory Service and the National Radiological Protection Board, whose roles will be assumed by the Health Protection Agency. The work of the NHS Modernisation Agency, which has been at the forefront of the current government抯 reforms of the NHS, is to be subsumed by various parts of the NHS.
The move comes after a Department of Health review of the work of its 42 health agency quangos, four of which have already disappeared.
Announcing the proposals, John Reid said: "The arm抯 length body sector has done a lot of good work, but it has grown over several decades and no longer meets current health and social care needs or those of future generations."
In October the department will set out the time frame for the changes, including plans to cut the 22
The abolition of the Commission for Patient and Public Involvement proved most controversial, although its network of patients?forums will remain. Established in January 2003, the commission is responsible for the local patient and public involvement forums, which formally replaced community health councils last December.
Harry Cayton, the government抯 director for patients and the public, said that the government remains committed to an NHS that is centred on patients. "I look forward to seeing the savings and the reduction in bureaucracy arising from the changes being translated into benefits for patients and frontline staff," he said.
But the commission抯 chairwoman, Sharon Grant, felt that the proposals "will be seen as betraying the government抯 promises to provide an independent voice for patients and the public in health." The Consumers?Association also criticised the decision, saying that it contradicted the government抯 stated aim of promoting patients?choice.
Laura McMurtrie, the commission抯 chief executive, said that the review had failed to recognise "the excellent work that has been done in setting up the network from scratch." The agency will push for a formal consultation process on the proposals, she said.
Malcolm Alexander, former director of the Association of Community Health Councils in England and Wales, felt that the government realised that it had "really messed things up badly," adding that although the commission was meant to replace health councils, "instead all we have seen is inexperienced central leadership, no public offices, no staff, poor support, and no money." A new democratic model was needed, he said. Responsibility for reviewing patients?complaints that have not been sorted out at a local level has been taken over by the Healthcare Commission.
Niall Dickson, chief executive of the health policy think tank the King抯 Fund, supported the move: "Too often the government抯 solution to every problem has been to establish an agency, with the result that the NHS has been drowning in an alphabet soup of acronyms. Let us hope this is the start of a more rational approach."(BMJ Karen H閎ert)