PM's adviser sets limit on NHS independence

The government cannot completely devolve the NHS from political influence, according to the prime minister's health adviser Professor Paul Corrigan, but there will be a ‘dwindling influence of the state' in the future.

Chancellor Gordon Brown recently asked health experts to examine plans for the NHS to be run by a devolved board to keep government at arm’s length. Under such an arrangement, ministers’ role would be limited to setting strategic objectives and the overall NHS budget (GP, 29 September).  

But speaking at health think tank the King’s Fund in London last week, Professor Corrigan said total devolution had ‘no practical possibility’.  

‘There needs to be politics somewhere,’ he said. ‘It’s hard to imagine a party manifesto which says: “Health: nothing to say — we’ll just take your money”.’  

He said it was unfeasible to free the NHS from the accountability of the electorate.  

‘The electorate can be unreasonable,’ Professor Corrigan said. ‘If the board is separate, the government can agree something with the electorate that has no practical possibility.  

‘Currently it can’t promise something wild because it will have to deliver it.’  

Politics would always play a part in the NHS, he said, from demonstrations over hospital closures to keeping politicians accountable in television interviews.  

Professor Corrigan also said that a service level agreement between the government and an NHS board would have to be so tight as to ‘frighten’ him.  

He said that ‘freedom of movement’ was one of the things primary care organisations most needed and wanted, and any such agreement would negate that. 

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