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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1338.
PMCID: PMC1906642

Tories want to free NHS of political interference

The Conservative party plans to free the health service from political interference by handing over control of the day to day running of the NHS in England to an independent NHS board.

The radical plan appears in a white paper that will form the basis of the party's health policy at the next general election.

Launching the document last week, the Tory leader David Cameron said that, in addition to the planned NHS board, a pledge to scrap national targets and devolve more power to doctors would further enhance the independence of the NHS.

The shadow health secretary, Andrew Lansley, said, “We need a service where the government and parliament set the framework, determine the overall resources, [and] agree the objectives and outcomes which need to be met, but don't try to interfere in the day to day decisions about patient care.”

He said that the proposed NHS board would “represent patient and public interests.”

He added, “It will create powerful incentives for healthcare organisations—publicly owned and independent—to deliver greater quality and efficiency, which will benefit from a structure of independent regulation [and] which enables investment for more capacity and competitive incentives to deliver efficiency and quality.”

Board members would be chosen by the health secretary and would be accountable to the Cabinet.

However, the Labour party's chairwoman, Hazel Blears, said that the Tories' NHS board sounded like “a return to the days of nationalised industries.”

The Tories also pledged to put senior doctors in charge of local budgets, with power to decide how money is spent. Mr Lansley warned, however, that doctors who performed poorly in this role would have their salaries cut.

Hamish Meldrum, chairman of the BMA's General Practitioners Committee, said that family doctors “would have to be convinced of the need” for changes to the current system of performance related pay.

But many commentators remarked that, apart from the NHS board and the pledge to do away with national targets, the Labour and Tory health policies were similar.

Gill Morgan, chief executive of the NHS Confederation, which represents most NHS organisations, said: “We welcome the Conservative party's commitment to the values of the NHS and a tax funded system. It is good news that their proposals contain no violent change of direction or major reorganisation. We need a period of stability.”

Niall Dixon, chief executive of the healthcare think tank the King's Fund, said that the Tories were “right to build on existing reforms” rather than attempt “a further potentially damaging reorganisation.”

However, he added: “We need to be cautious about the value of an independent NHS board. Handing power to such a board would not, by itself, guarantee local autonomy or a greater voice for patients.”

He also questioned the wisdom of scrapping targets. “While central targets have certainly brought problems—not least the sheer number of them and some unintended consequences—they have been a big factor in driving down unacceptable waiting lists,” he said.

The Tories also plan to extend patients' choice by allowing people to choose any hospital in the country, NHS or private, and to form a new “HealthWatch” patients' group with a power to veto hospital closures.


NHS Autonomy and Accountability: Proposals for Legislation can be found at

Articles from The BMJ are provided here courtesy of BMJ Publishing Group