29 June 2007
Prime Minister Gordon Brown is unlikely to introduce an independent National Health Service board and could instead opt for a constitution covering the sector, say insiders.
In his first pronouncement as prime minister after returning from Buckingham Palace on June 27, Brown said that 'change in our NHS' was one of his priorities.
But senior insiders said an independent NHS board was unlikely in the short term. The Conservative Party has backed such a move, but organisations such as the King's Fund health think-tank have cautioned against it.
A major report on the Department of Health, published by the Cabinet Office last week, suggests another overhaul could further destabilise a malfunctioning department.
The DoH is the second worst-performing Whitehall department according to its Departmental Capability Review released on June 22. Only the Home Office, described last year as 'not fit for purpose', is considered worse.
The independent review team found that the DoH lacks leadership, vision and a clear plan for the future. Although the assessment does not cover ministerial performance, the study led to criticism of outgoing Health Secretary Patricia Hewitt, an early casualty of Brown's reshuffle.
The DoH's ability to 'set direction' was reported as an area of 'serious concern' – the only Whitehall function to achieve the lowest rating outside of the Home Office. Three other areas are described as requiring 'urgent development'.
'There is currently no single clear articulation of the way forward for the whole of the NHS, health and wellbeing agenda. Staff and stakeholders are unclear about the vision for health and social care and feel little sense of ownership of it,' the review concludes.
However, the DoH scored well on its delivery assessments: it is on schedule to meet 12 of its 19 Public Service Agreement sub-targets, including plans to cut heart disease and cancer mortality rates.
Three senior health officials issued a joint response and promised to publish a plan for improvement. Permanent secretary Hugh Taylor, NHS chief executive David Nicholson and chief medical officer Liam Donaldson acknowledged that the department's outward focus 'has at times been at the expense of clear and consistent leadership'.
PFjun2007
