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Thursday, 17 February, 2000, 02:53 GMT
'Take politics out of the NHS'

operating theatre NHS facing growing pressures

Politics need to be taken out of the NHS and the public and health workers brought into the debate on what it can and cannot do, says a major report.

The King's Fund charity's report, Facing the Future, says the NHS has become too much of a political football as the government has sought increasingly to launch new initiatives to deal with rising public demand, the ageing population, media focus on rationing and other issues.

At the same time, it says, central institutions have become weaker and information on access to information needed to ensure initiatives are successful is scarce.

The NHS is still poorly equipped to understand what people need from it, and is unable to plan its long-term future in a way that meets those needs
Anthony Harrison, King's Fund
The report says this approach leads to short-termism and proposes that the public and health workers be brought more into debates on funding and that more information be sought on new forms of managing and structuring the NHS.

However, its authors, Anthony Harrison and Jennifer Dixon, say recent policies, such as the introduction of the National Institute for Clinical Excellence, have gone some way to improving the situation.


"Much of the current government's programme is very promising," said Mr Harrison. "The growing spirit of co-operation and responsiveness in the NHS bodes well for the future. But major obstacles to progress remain.

"The NHS is still poorly equipped to understand what people need from it, and is unable to plan its long-term future in a way that meets those needs.

"We need more long-term thinking at the highest level."

The report says the overall structure of the NHS has remained largely unchanged since it was set up, despite reforms in the 1980s and 90s, with GPs still acting as the gateway to the service.

The authors want to see a more radical approach, for example, they suggest that emergency service staff could set up their own doctor-led trusts and manage their own budgets.

Also proposed is more sharing of information on which systems work.


In addition, the authors want to see clinical staff such as doctors trained more in non-medical issues so that they can have more of a say in debates on funding and management.

The report says there is not nearly enough research into non-medical issues, such as how many staff are needed for a particular specialism and how staff can work across professional boundaries.

And it calls for more research into areas such as how to control drugs prices, the setting up of committees of professionals to define broad categories of what the NHS can fund, a Costs Inquiry similar to one carried out in the 1950s and a "demand audit" to see, for example, what effect government initiatives will have on demand for services.

The report says there will always be a gap between public demand and what the NHS can provide, although it agrees funding could be increased.

"Funding the NHS to the EU average, as recently pledged by the prime minister, is urgently needed and will be a big help," said Jennifer Dixon, "but it won't solve all our problems."

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See also:
24 Jan 00 |  Health
Winston calls for NHS spending pledge
10 Feb 00 |  Health
NHS 'needs 4,000 more beds'
17 Jan 00 |  Health
Waiting list drive adds to the burden

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