An independent board should allocate NHS resources to different parts of the country
At the moment “The Department of Health allocates revenue funding to primary care trusts (PCTs) on the basis of the relative needs of their populations and in line with pace of change policy.” However the department of Health allocating the NHS’ resources means that it is open to political influence. An independent board to allocate resources would prevent this.
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Would not be political
Dr Hamish Meldrum, chairman of the British Medical Association, suggests that concrete measures such as the creation of a national independent board to oversee the day-to-day operation of the NHS would help depoliticise it.[[http://www.guardian.co.uk/society/2009/jan/21/nhs-constitution-reaction]] This would have a lot of power to control policy through funding and help stop the NHS being a political football. At least the national independent board would take action and help push forward the development and relationships of the NHS.
It would be very difficult to prevent an 'independent board' from being political. If it rejected something the Department of Health wanted then sooner or later it would come under pressure from the department which would make it political. The NHS is such a political subject that independence could never be guaranteed.
Can look at new ways of funding
An independent board would be able to look at new ways of funding the NHS which would help provide for the independence of the NHS much as the licence fee does for the BBC. This independent board would be able to look at possibilities such as social insurance as a serious model for future funding of healthcare. This works in most European countries and is a good way to create a responsible and patient centred health system. More importantly such a system ensures that only those on what can be deemed good wages will pay insurance, those that can’t afford to for whatever reason would continue having their healthcare provided by general taxation. This is both progressive and fair and would allow on those in society with the greatest need to be covered through taxation, the majority would pay into insurance schemes and would therefore reduce the pressure on government expenditure.
There is no reason why the NHS should not remain tax funded. There is little problem with the system as it is. If the alternative is to allow people who can't afford insurance free healthcare, why not keep the current system of simply allowing everyone to have free health-care and tax the rich more instead of charging them both taxes and insurance?
It also seems very unlikely that such a comprehensive review would actually occur. The conservative proposals are simply about redistributing the money there is from central government not finding new ways of paying for the NHS.
A guardian of care standards
We need to look at the role that government plays in the NHS and whether it should move towards being the guardian of healthcare, ensuring access for everyone and setting regulation/standards. This would be made possible if the allocation of resources is being overseen by an independent board. The Department of Health would be able to concentrate on improving standards and making sure that the NHS provides the same opportunities for everyone so for example making sure that there is no longer a postcode lottery when it comes to some drugs.
At the same time the money would be targeted towards those areas that need it most. “We’re going to introduce a health premium that targets resources on the poorest areas so we banish health inequalities to history. With our plans, the poorer the area, the worse the health outcomes tend to be, so the more money they can get.”[[Tory manifesto has records for all, ehealth Europe, 4th Jan 2010, http://www.ehealtheurope.net/news/5513/tory_manifesto_has_records_for_all%5D%5D
The current NHS constitution is a better way of setting out NHS priorities and governance.
On 21 January 2009 Gordon Brown signed the first Constitution for the NHS. This document explains clearly a collection of legal rights, pledges and responsibilities for both patients and staff for the next ten years. The new NHS constitution has great all-round potential. David Pink, chief executive of National Voices, says that "sixty years on from the founding of the NHS, we need a different relationship with our health service, one that makes clear how the NHS will meet the expectations of the patients, the public and its staff". He goes on to explain how it is no longer enough for the government to set the funding and for the patients to be grateful for their treatment but we need a service that "listens and responds to the needs of the people it serves".[[http://www.guardian.co.uk/society/2009/jan/21/nhs-constitution-reaction]] Thus, the NHS constitution provides potential for greater patient-staff service, higher expectations and a modern partnership between the NHS, patients and communities. It also means that much of what would be achieved by an independent board is already being done.
A computer could do it better
Why appoint an independent board to distribute the global NHS budget to local primary care trusts, and at the same time add to admin costs as this would be adding in a layer of bureacracy. Instead a computer that already allocates 80% of the NHS budget, one of the most sophisticated formulas for allocating public money anywhere in the world, could carry out the job just as well and in a much less biased fashion.[[John Appleby, Come off it Dr Cameron, The Guardian, 4th Jan 2010, http://www.guardian.co.uk/commentisfree/2010/jan/04/cameron-changes-nhs-happened-already%5D%5D
How would we work out when there needs to be changes in funding and it cant be a change throughout the whole NHS. At that point someone needs to come in and make decisions. It would be better that this was an independent board rather than the Department of Health.
What do you think?