Overlord for health and social care

15 Jun 00
Integration of health and social services in England came a step closer this week as Health Secretary Alan Milburn announced a new post amalgamating the positions of chief executive of the NHS Executive and permanent secretary at the department.

16 June 2000

The current NHS Executive chief executive, Sir Alan Langlands, leaves in July and his deputy Neil McKay, who will 'act up' until an appointment is made in the autumn, is seen as one of the leading contenders for the new job. Chris Kelly, the current permanent secretary, has ruled himself out of the running.

Milburn described the post as 'probably the biggest and most exciting' in the public sector and 'at the cutting edge of health and social care reform'. He said: 'The task is to drive through a modernisation programme to create 21st century health and social care for the people of this country.'

The position, which will have an annual salary of £150,000–£200,000, is expected to attract senior civil servants in other departments, as well as those from outside the public sector.

The new office will pull together the department's three functions – the NHS, public health and social care – breaking down at national level the barriers ministers wish to abolish at local level.

Whitehall sources said splitting public health and social services from management of the NHS had led to tensions in the department, most recently during the winter flu crisis when rival groups of officials took charge of vaccinations, social care and hospital admissions.

'There have been numerous turf wars between the [NHS] Executive and departmental officials. You can't always separate operational responsibility from policy, especially with something as political as the NHS,' said a senior official.

Implementing the NHS National Plan, which will be published next month, will be top of the new overlord's agenda. Last week the prime minister and the health secretary hinted that the plan would make the NHS responsible for all elderly care, including that currently delivered by local authorities.

The NHS Confederation said the move would help bring together health and social services but warned that partnership must be the key. 'There must be no going back to the old-style mandarin methods,' a spokesman said.

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