Monitor calls for more freedom for NHS purchasers

20 Oct 05
The government should free local health commissioners from central control, the head of the foundation trusts' regulatory body said this week.

21 October 2005

The government should free local health commissioners from central control, the head of the foundation trusts' regulatory body said this week.

Bill Moyes, executive chair of Monitor, told a King's Fund conference on NHS regulation on October 18: 'I think [the Department of Health] has to act more like a headquarters of a major insurance company, handing out the money so we get the best value, but leaving local purchasers to manage the targets.'

Moyes argued that there should be a clear separation between an economic regulator and a separate inspectorate overseeing quality of service.

The DoH is reviewing how health care regulation should be restructured to reflect the introduction of competition and Patient Choice.

But the chair of the Healthcare Commission, Sir Ian Kennedy, insisted that regulators should ensure that commissioning abides by centrally set principles.

'Demand-side levers are still needed to ensure commissioners act as proxies for the public in an efficient and informed way, responsive both to local needs and reflective of demands for equity nationally,' he said.

The conference took place against a background of rivalry over the inspection of NHS bodies, which the DoH said the review was looking to 'streamline'. The National Audit Office, the Healthcare Commission and the Audit Commission all currently have a role.

Moyes said: 'The present system is messy and not sustainable. Inspection can improve performance and protect patients, but if it does not function properly that role falls apart.'

The Audit Commission this week set up a separate unit — a trust practice — to oversee its auditing of NHS trusts during their transition to foundation status in a clear bid to cement its role as 'the single largest auditor' of foundation trusts.

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