The Telegraph notes a new report from the Nuffield Trust by Brian Edwards, Emeritus Professor of Health Development at the University of Sheffield. As soon as Gordon Brown foreshadowed some change in governance for the National Health Service, the expectation of growth in paper expended on this topic was predictable. The actual mathematical equation is not to hand.
The usual bugbear, to be attacked, is a politicised NHS. Alternative methods of governance will be designed to reduce political interference yet maintain ministerial responsibility.
"It is time to give the leaders of the health professions room to move the system. Ministers can never escape their ultimate responsibilities for the health of the people of the UK and creating more space for the NHS to modernise will require an act of great political courage and wisdom." The use of modernisation and managerialism to tinker with the structures, yet not the underlying philosophy, locates the report in the professional lobby for moves towards less accountability to Parliament. The structure of the NHS would be nearer to the Post Office or another agency. Ministers would shuck off their responsibilities to the Chief Executive and point Parliament in that direction. Yet, the greater flaw is that ministers think themselves responsible for the health of every individual in the nation. This is the responsibility of the individual. By maintaining this fiction, ministers have taken upon powers upon themselves to render health a collective enterprise modelled on a zero sum economy, and punish risk taking behaviour that is calculated as costing too much. Health is already politicised, and this tinkering will not abate or reverse that trend.