18 April 2008
Leading finance officers in Scotland have warned that direct elections to health boards will not by themselves improve public and patient involvement in the running of the NHS or lead to better management.
Responding to the Scottish government's consultation on the Local Healthcare Bill, CIPFA in Scotland says there is no evidence that direct elections would advance the principles of the Good Governance Standard for Public Services, which was drawn up by an independent commission in 2005.
Ministers believe elections would help to achieve their aim of encouraging greater public and patient involvement in the planning and provision of local NHS services.
According to CIPFA, the fact that this is seen as a current 'weakness' indicates that governance arrangements in the NHS need strengthening, irrespective of whether there are direct elections.
The institute believes the government's objectives could enhance two of the principles of the governance standard – focusing on outcomes for citizens and making accountability 'real.'
But it argues that 'there is no evidence presented in the consultation to illustrate how direct elections will advance these two principles'.
Don Peebles, policy manager for CIPFA in Scotland, said: 'It is our view that the consultation document does not make the case that direct elections will ensure increased public engagement.
'CIPFA believes that increased public engagement will follow from embedding the good governance standard in NHS boards and this is necessary irrespective of the proposals.'
CIPFA stresses the need for 'clarity' in the role and responsibilities of NHS boards and their membership. 'NHS board members, whether elected or not, should have a personal development plan, with appropriate training and development, to meet the requirements of their roles and responsibilities,' the response says.
The institute warns that direct elections would remove the ability of boards to ensure they contain appropriate skills, viewpoints, abilities, knowledge and experience to underpin their good governance.