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Chairman of the BMA Dr Ian Bogle
"This has been promised on many occasions"
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Wednesday, 25 April, 2001, 11:48 GMT 12:48 UK
NHS shake-up announced
Health Secretary Alan Milburn overseeing NHS reforms
Alan Milburn to give doctors and nurses more power
A radical shake-up of the NHS which will reduce the number of health authorities in England has been announced.

The move, designed to give doctors, nurses more power, was unveiled by Health Secretary Alan Milburn at a conference of doctors in London on Wednesday.

We have got to make sure that the people at the frontline have a greater say

Alan Milburn, Health Secretary
It is designed to save 100m in bureaucracy costs which can be invested into patient care.

By 2004 two-thirds of health authorities will have merged, reducing bureaucracy as their numbers fall from 99 to 30 in England.

The remaining 30 health authorities will be renamed and will cover larger areas, averaging 1.5m people each.

Hospital trusts and local primary care trusts, run by doctors and nurses, will be accountable to the new health authorities but will have greater operational freedom.

The new health authorities will be a bridge between Whitehall and local NHS services and effectively abolish the layers of bureaucracy created by regional offices and the NHS Executive.

It is planned that control of NHS spending will, in large part, pass to primary care trusts.

By 2003-04 the trusts will be responsible for allocating 75% of the NHS budget of 57bn.

In 1997 the proportion of the budget controlled by GP fundholders was just 15%.

Modernisation agency

The health secretary outlined the plans at the launch of the NHS Modernisation Agency on Wednesday.

This agency will oversee best practice throughout the health service.

Decision making in the provision of health care should rest as closely as possible to the consulting room

Dr Ian Bogle, British Medical Association
Mr Milburn told the BBC: "We have got to make sure that the people at the frontline who actually provide the treatment and the care have a greater say and greater control over the resources that they provide."

He accepted that people working in the NHS might be suffering from "change fatigue" and said the changes would be phased in carefully and with local consultation.

The Conservatives have criticised the Health Secretary for trying to centralise the NHS.

Shadow health secretary Liam Fox said: "It is flattering that Alan Milburn should again steal Conservative ideas.

"He is clearly incapable of original thought. The Conservatives' policy is to decentralise the NHS."

'Election gimmick'

Nick Harvey
Nick Harvey MP said the plans were a "gimmick"
Nick Harvey, for the Liberal Democrats, dismissed the proposals as a "pre-election gimmick".

He said: "It's a popular idea that there ought to be fewer managers in the health service, but over the last two years I have not found a single doctor or nurse who actually subscribes to that idea.

"If anything the message I get from doctors and nurses is that they think there are too few managers, and I am not sure they are going to welcome having the work that managers are doing thrust upon them on top of the clinical work they are already responsible for themselves."

Dr Ian Bogle, chairman of the British Medical Assocation, welcomed the announcement.

He said: "Decision making in the provision of health care should rest as closely as possible to the consulting room.

"The awareness of what is required for patients rests at a local level and the people who are delivering and receiving health care in an area are the ones who are likely to know where local investment should be made.

"But anything that involves taking doctors away from their patients is going to increase the workforce and workload problems that are already there and we are desperately short of both GPs and consultants.

"Local decision making will only work if generous resources are provided locally to allow that process to happen."

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See also:

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Blair unveils NHS blueprint
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Nurses' powers to be increased
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