Tuesday, May 08, 2007

Elected Healthcare Commissioners


The day-to-day running of the NHS should be separated from national politics to ensure its long-term future, doctors' leaders recommended today.

The British Medical Association (BMA) suggested a written constitution overseen by an independent board of governors, that would include a charter explaining what the public can expect from the NHS and what is expected of them.

The constitution would also retain the core values of the NHS while incorporating new ones such as a commitment to research.

I agree that government should have no say in the day to day running of the NHS but I don’t think it should be run by a board of governors. I think Healthcare Commissioners should be elected for the NHS. I have two options for elections:

1. Apparently there are about 700 hospitals (I worked it out myself by reading this). They would be elected by the people in the catchment area and would be responsible for not just the hospital but the healthcare system in the catchment area so this would include dentists and doctors’ surgeries.

2. Healthcare commissioners would be elected on a county basis. This would number around 86 seeing as there are 86 counties in Britain. They would be responsible the healthcare system in the county so this would include dentists and doctors’ surgeries.

Whichever way that they are elected individually they would set wage levels of NHS staff and manage the day to day running of the area that they are responsible for. It would be then split up into 4 countries. They would each go to a ‘Health Assembly’ (can’t think of a better name) in their respective countries about 6 times per year where they will discuss NHS policy and most crucially of all set the NHS tax rate and decide how much each area will get in NHS funding. That’s right. The tax for the NHS will also be taken out of the hands of government and given to these Healthcare Commissioners. They Health Assembly would also be responsible for new drugs

When the budgets are set for each hospital it will be up to each Healthcare Commissioner to stay within budget so paying NHS a lot might be a bad idea

If the Healthcare commissioners are doing a bad job the electorate will be able to hold them to account and get rid of them.

I am starting to favour option 2 as there would be less of them which would make it easier to discuss NHS matters. 700 would mean we have something like our present Parliament and when it comes to the NHS I don’t want that.

Seeing as the government won’t be running the NHS a whole heap of civil servant jobs would disappear, meaning that the NHS would save money. The only thing that the Department of Health would be concerned about is research into health so most of the employees (probably 95%) could be let go.

Seeing as the Healthcare assembly would be responsible for new drugs they will decide how they are licensed and what kind of procedures the pharmaceutical companies will have to go through which might bring down the cost of drugs if they don’t have such stringent rules as we presently do which would save even more money.

1 comment:

james higham said...

Interesting take. I haven't much thought about this issue.