NHS reforms have failed to take the politics out of the NHS

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The creation of NHS England has failed to take the politics out of health care provision in England, argues a new report from the Institute for Government and The King’s Fund.

NHS England – dubbed 'the world’s biggest quango' by the then Shadow Secretary of State for Health, Andy Burnham – was established five years ago by the Health and Social Care Act 2012 as a statutorily independent board with the aim of ending 'political interference in the NHS'. Yet the current Secretary of State, Jeremy Hunt, has been as closely involved in NHS performance and planning as his predecessors.

Nor has its creation led to the NHS being run on 'quasi-market' lines as its principal architect, Andrew Lansley, intended. Instead – despite the fears of critics – the Act turned out to be the high-water mark of faith in choice and competition. It has been followed by a return to a more managed system, with the balkanised bodies it created being slowly but surely brought together and merged.

'The world's biggest quango', written by Nicholas Timmins, draws on extensive interviews, many of them exclusive, with some of those most closely involved in the first five years of NHS England. Timmins reveals how personality continues to play an important role, with Health Secretary Jeremy Hunt and NHS England Chief Executive Simon Stevens both having very different styles to their predecessors.

One area of successful reform, according to the report, is in giving the NHS its own genuinely independent voice and action, essentially for the first time. Jeremy Hunt says this is 'the one thing I would not have done differently' had he been legislating. But the moves to create a more unified board at the top of the NHS and more integrated services locally means that, at some point fresh legislation will be needed, the report concludes.

Nicholas Timmins, the author of the report said: 'What happened after the 2012 Act is not what most people expected. The question now is what happens next... and when.'