Reforming the NHS: accountability

Last week, Reform published its 2011 public service reform scorecard. It judged each major government department against the three criteria set out by David Cameron: accountability, flexibility and value for money. The report finds the Home Office’s policing reforms succeeding on all three fronts, but inconsistency across other government departments. The Government’s health reforms are awarded grade D overall, with an E for accountability, a D for flexibility and a D for value for money. Here’s how the coalition can get its NHS reforms back on track.
 
The government has recognised the need for fundamental reform of the NHS. The proposals announced in the July 2010 White Paper are substantial. However, the government’s plans leave accountability divided between patients, doctors and local authorities. Healthcare delivery continues to be centralised: Andrew Lansley has placed a moratorium on hospital closures, and the government will maintain national direction of the workforce. The decision to ring-fence health spending means that health policy is based on increasing inputs and not value for money; significant waste has been identified, but it should still be protected.