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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1336.
PMCID: PMC1906651
NHS independence

An NHS board is the way forward

Layla Jader, consultant in public health medicine

The reports on removing the NHS from direct government control are heartening.1 2 3 There is, however, an option that gives the NHS its independence and removes the hegemony of one political party. Balancing political input4 into an NHS corporation that fully manages the NHS as described by Edwards3 will satisfy critics who complain that we can never remove politics from the NHS and that we need politicians to drive the change. The board should have MPs representing the main political parties, in addition to elected members from health professionals, trade unions, managers, and patient groups. One member one vote with two third majority decisions will ensure that no one party will ever again run the NHS with an eye on the next election—an electoral college as described by Edwards with one difference: members are democratically elected from their organisations rather than nominated by ministers.

Such a model would be ideal for Wales as it currently does not have foundation trusts or large scale privatisations. Since the May assembly election it has had a minority Labour government seeking coalition with the Liberal Democrats one day and Plaid Cymru the next, without yet settling on a solution—so, why not an all party NHS board?


Competing interests: None declared.


1. Hawkes N. Nuffield Trust backs independence for the NHS. BMJ 2007;334:1129 (2 June.) doi:10.1136/bmj.39231.396262.4E [PMC free article] [PubMed]
2. British Medical Association. A rational way forward for the NHS in England London: BMA, 2007
3. Edwards B. An independent NHS: a review of the options London: Nuffield Trust, 2007
4. Jader L. It is time to separate the NHS from direct government involvement. BMJ 2006;332:1518

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