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CHI: The basics
Alan Milburn developed the commission
Described as one of the biggest reforms to the NHS since its creation in 1948, the Commission for Health Improvement - or CHIMP - is officially launched on Thursday. As watchdog for the health service in England and Wales, its role is similar to that of Ofsted, the education standards body. As such, some commentators have relabelled it Ofsick.

What is it?

The new NHS
Headed by Peter Homa, CHIMP will tour hospitals, GP practices and other NHS centres to judge whether or not standards of treatment are up to scratch.

These standards will be set by the National Institute for Clinical Excellence, or NICE.

It begins its work on the first of November, when it will start to recruit a staff of 400 doctors, nurses, and other health care professionals.

What will it do?

The staff will monitor the performance of every aspect of the NHS in both England and Wales in a four-year rolling programme of inspection visits, starting, they hope, in April 2000.

Peter Homa will run CHIMP
During these, it will check the hospital's own performance figures, and examine whether managers and senior doctors are doing enough to improve standards through training and education.

In cases where performance is extremely poor, it will have the power to send in hit squads to take over the failing hospital.

If whistleblowers alert CHIMP to serious problems at a particular hospital, it has the power to undertake a spot check, and, with the agreement of the health secretary, remove an entire hospital trust management board if the service is clearly failing.

One of its first targets is expected to be to enforce high standards in cancer care across the NHS.

Why does it exist?

The government hopes it will raise standards and stop scandals and tragedies occurring - former Health Secretary Frank Dobson emphasised this role following the Bristol heart babies affair in 1998.

And in enforcing NICE rulings, it also hoped the commission will speed up an end to postcode variations in care, where the quality of treatment varies depending on where the patient lives.

Will it work?

Critics say that given the size of the job, inspections risk either being too superficial or over bureaucratic.

Dr Ian Bogle welcomed the launch
However, doctors' representatives and mangers are willing to give the commission a chance.

Robert Naylor, an NHS trust manager, told the BBC: "I hope it does not become too inspectorial. I hope it will be an organisation that will help us to continue to improve and to facilitate that process rather than be an organisation which is continually critical."

Dr Ian Bogle, chairman of the British Medical Association, said: "I have worked with the Commission's chairman Dame Deidre Hine in the past and have already met her in her new role to hear about the work of the new body."

Whose idea was it?

CHIMP was first proposed in the 1997 White Paper, The New NHS.

Frank Dobson emphasised the body's powerful role
Current Health Secretary Alan Milburn was responsible for the development of CHIMP in his former role as a minister under Frank Dobson at the Department of Health.

At the time, he promised a tough commission.

"There will no longer be any hiding place for those doctors or managers who fail to acknowledge the seriousness of problems inside their own organisation," he said.

"In such cases, the commission will be able to recommend to the Secretary of State that new teams of experienced doctors, nurses and managers are sent in immediately to take over the running of a failing service."

BBC News' Daniel Sandford: "The Director General has the power to take control"
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01 Apr 99 | Health
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