Governing the NHS

An independent NHS board has been advocated by a number of commentators, who believe it will reduce both micromanagement and day-to-day political interference in the running of the health service. This report argues that an independent board would be limited in its ability to achieve these aims. It suggests a number of alternative options to an independent board that build on the increasing operational independence the recent reforms have offered. These options would help secure a better balance between public accountability and local autonomy within a more devolved health care system.

ISBN	1857175638	DEWEY edition	DC22
ISBN13	9781857175639 (What's this?)	Pages	84
Publisher	King's Fund	Published in	London
Imprint	King's Fund	Height (mm)	210
Format	Paperback	Width (mm)	148
Publication date	17 Jan 2008	Spine width (mm)	7
DEWEY	362.10941	Academic level	Professional / Scholarly

		Why an independent board?		4
		Politicisation		4
		Micromanagement		9
		Summary		16
		The evolution of political and managerial control of the NHS		17
		Local management autonomy		17
		Regionalisation		18
		The separation of policy formulation and implementation		20
		Summary		24
		Independence in the context of current NHS reforms		25
		Autonomous providers		25
		Devolved commissioning		27
		Arm's length bodies		29
		Summary		31
		Alternatives to an independent board		33
		Adopt the principle of subsidiarity		33
		Strengthen the role of parliament		40
		Redefine 'bedpan' doctrine		44
		Strengthen local accountability		46
		Increase transparency		50
		Create an NHS constitution		51
		Conclusions		59
		References		60
		Linked publications		73

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