Health Department mandarin says reforms are a “nightmare”
Reading the minutes of the the Public Accounts Committee for 25 January, as one does while one waits for kickoff in the Super Bowl, this leapt out at me.
After a complicated discussion about “risk pools” in the new NHS with Sir David Nicholson, Chief Executive of the NHS,* Richard Bacon, Conservative MP for South Norfolk, asked him about accountability.
What I am really asking is if a GP consortium decides to go haywire and runs off to the Netherlands Antilles with the money — we have seen public money going off to Caribbean tax havens since I have been on this Committee, so it is not such a stupid question — will the chief executive or managing partner of the GP consortium be coming before us to explain his actions, assuming he has not been arrested and in jail, or will you be?
Sir David Nicholson: It will be me.
Richard Bacon: It will be you, okay.
Margaret Hodge (Lab, Barking) (Chair): And will you on hospitals?
This was answered by Una O’Brien, Permanent Secretary of the Department of Health (above):
The accounting officers — which is a different role from the accountable officer of the consortia — are directly accountable to Parliament where there are NHS foundation trusts.
Margaret Hodge (Chair): So we are expected to see however many foundation trusts we end up with?
Una O’Brien: Yes. On the specifics of what goes on inside that operational unit of a foundation trust, that is what the legislation currently says.
Margaret Hodge (Chair): It is a bloody nightmare.
Una O’Brien: Yes.
*The risk pools, a form of pooled insurance between groups of GP consortia, reveal some of the hidden complexity of the new form of NHS market, but Sir David eventually managed to make clear that they would apply to conditions specified in advance. I suspect that the drafting of those contracts is going to be another nightmare.Tagged in: nhs, public service reform
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