NHS Commissioning Board or NHS England?
In England is the country, and the country is England I suggested that English ears now substitute the word 'England' for ambiguous phases like 'the country' and 'this country', and, given that fact, politicians would be well advised to put emphasis on 'England' when it is England of which they speak.
So I was delighted to read Liz Kendall referring to the English NHS.
This is a complicated set of amendments and I will explain what I believe they really seek to achieve. The amendments give the board or, as I will now call it, NHS England more freedom to spend its money how it wants, but they give consortia, or clinical commissioning groups, less freedom to spend the money how they want. They also take away the Secretary of State’s ability to specify for the board and individual consortia how much they may spend on admin costs. That is my understanding of the amendments.
Amendment 85 deletes the current clause in the Bill that gives the Secretary of State the power to tell the board and consortia how much they may spend on administrative costs. Instead, it gives an overall limit, which gives the board the power to shift money around, including resources for admin costs.
A pattern is emerging. The commissioning board, or NHS England, will end up being a super-quango that can spend as much money as it wants on admin costs with far greater power over clinical commissioning groups. I think that GPs and others who were enthusiastic about the Government’s plans will see, step by step in the post-pause Bill, their power and influence taken away by the board in ever more centralised control.
Whatever the Minister says in his description of the financial changes, they are not technical amendments; they are amendments that will shape and drive how the NHS is run, giving NHS England greater control, commissioning groups less control and, overall, taxpayers less control over how admin costs are spent.
In light of this I wonder if the Commissioning Board will change its name or slip the word 'England' into its published remit.
Role of the NHS Commissioning Board
Nationally accountable for the outcomes achieved by the NHS, the NHS Commissioning Board will provide leadership for the new commissioning system. It will provide the support and direction necessary to improve quality and patient outcomes and safeguard the core values of the NHS.
The NHS Commissioning Board has overall responsibility for a budget of £80bn, of which it will allocate £60bn directly to GP consortia. It will directly commission a range of services including primary care and specialised services and have a key role in improving broader public health outcomes.
The Board’s central role is to drive improvement in outcomes for patients, ensuring a fair and comprehensive service across the country. It will also promote the NHS Constitution and champion the interests of patients, using choice and information to empower people to improve services.
Accountable to the Secretary of State via an annual mandate, the NHS Commissioning Board will be an independent, statutory body, free to determine its own organisational shape, structure and ways of working.