Proposals for an independent NHS board should be treated with caution, says The King's Fund

Responding to the Conservatives' White Paper on health, published today, Niall Dickson, Chief Executive of the King's Fund, said:

'The Conservatives are right in trying to offer greater freedom to NHS organisations, to re-engage doctors in managing the NHS and to create greater public accountability and choice – and in trying to do that by building on existing reforms, not by a further potentially damaging reorganisation.

'But we need to be cautious about the value of an independent NHS board. Handing power to such a board would not, by itself, guarantee local autonomy or a greater voice for patients. The risk is that we move from one centralised system to another – and one that is no longer directly accountable to ministers.

'The Conservatives' plan to abolish all central targets also needs to be considered carefully. While central targets have certainly brought problems – not least the sheer number of them and some unintended consequences – they have been a big factor in driving down unacceptable waiting lists.

'In the end, those responsible for the nation’s health need to maintain all the levers for bringing about change: perhaps a smaller number of very meaningful targets; greater accountability at local and national level; strengthened professional practice for clinicians; financial incentives that support good health outcomes, not just activity; patient choice and competition and effective regulation.

'The Conservatives are right to try to think through what it means to have a market in health care. At present there is a growing market, but this is not reflected in the way we plan and regulate health. A clear set of rules for competition across the NHS is needed to ensure that the emergent market works in the interests of patients.'

Notes to editors: 

  1. For further information or interviews, please contact the King’s Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
  2. The King’s Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; conferences, seminars and workshops; publications; information and library services; and conference and meeting facilities.