29 March 2002
Devolution of power and resources down to primary care trust level has emerged as one of the key principles behind Labour's health policy. But former NHS Confederation chief executive Stephen Thornton told the minister that PCTs will have to decide whether to cut some services to finance their priorities. Consequently, the NHS could end up funding services in some areas that it does not in others, which could lead to lurid headlines, he said.
Speaking at the King's Fund Open Day in London on March 26, Thornton said: 'There is a tension between the new freedoms and the trap that somehow everything needs to be done. Politicians need to be brave and say, "It ain't going to be like that" if we are going to move forward and innovate.'
Blears acknowledged the need for political leadership. 'As politicians we need to be brave,' she said. 'The service must be run for the benefit of people and we can't run it from Whitehall.
'Priorities must be set at community level and this will involve some risk-taking but if community participation is right, people will feel ownership of decisions. That strong relationship will enable local health services to take risks.'
NHS chief executive Nigel Crisp said there was a tension between central and local priorities but some matters were better dealt with in Whitehall.
'We must centralise the way we develop information management and technology and take a lead on the values and behaviour we want from our leaders, so there is an accepted way of doing things in the service,' he said.
'There are some things that only we at the centre can do, such as taking on vested interests.'
He added that local managers needed to be more entrepreneurial. 'Some people say, "We're not allowed to do that". They are using it as an excuse. I wish people would stop asking for permission to do things when they don't need to.'
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