Professor Malcolm Grant, who is married to a GP, told the House of Commons health select committee pre-appointment meeting in London on Tuesday that he wanted to see responsibility for failures in care and budget overspends pushed back to the front line.
The ‘buck will stop with CCGs’, the prospective future NHS Commissioning Board chairman said.
Professor Grant said it would be down to CCGs to resolve issues with primary care at a local level.
‘What they cannot do is to keep pushing that accountability back up the chain…they cannot simply complain to the secretary of state who no longer has this responsibility.’
If there are problems with a local hospital then it will be down to the CCGs to talk to the hospital and ‘use their commissioning power to change what is happening’, Professor Grant said.
In order to ensure that CCGs are financially accountable, there will need to be ‘an accountable officer for each CCG’, Professor Grant said.
In the instance of clinical failure, the NHS Commissioning Board, the Care Quality Commission and other agencies will all have to power to intervene, he said.
‘The board is going to have to ensure it has the intelligence flow to detect failure coming in at any time,’ he said.
Responsibility for service re-configuration, described by Professor Grant as the ‘most difficult thing in the NHS’ will lie with CCGs ‘in the first instance.
‘But there is a process of consultation with other groups,’ he added.
Professor Grant was clear that he wanted the board to give CCGs the freedom to do things ‘their way’.
‘My natural instinct is to empower and to devolve responsibility and let people do what they are able to do,’ he said.
‘You and I can’t run a GP practice in Whitehall,’ he added.
When describing to the committee how accountability would pass from the Health Secretary to the NHS Commissioning Board, Professor Grant described the Health and Social Care Bill as ‘unintelligible’.
He said ‘I have to say by the way the Bill is completely unintelligible.’
Professor grant said the Bill created ‘an extraordinary transformation of responsibility within the NHS’ .
However he argued that the Health Secretary was not 'delegating' responsibility to the NHS Commissioning Board, but rather he was ‘passing over responsibility’.
The Bill allows the Health Secretary to hold the Board accountable and the Board to hold CCGs accountable through its relationships with them, Professor Grant said.