Government and the NHS : time for a new relationship?

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A wide range of public services - including higher education, housing associations and public service broadcasting - are now either funded, delivered, or regulated through agencies working at 'arm's length' from government. Is it time to consider a similar model for the modern NHS? Does the health service need to be freed from political interference, and allowed to get on with the job of delivering care as clinicians and managers think best, within a broad, agreed policy framework? "Government and the NHS - time for a new relationship?" probes the conceptual and practical challenges - as well as the potential benefits - of arm's-length governance for the NHS. It reviews past arguments, and considers how a contemporary 'arm's-length' NHS agency, accountable to Parliament, could work with government to improve health care. The paper concludes that this new relationship could help make the NHS more accountable, encourage a more transparent and inclusive approach to setting national health policy, and create greater ownership of targets by NHS staff. It could also liberate government from a narrow focus on health care, to engage with important issues such as the impact of poverty, environment, food, housing and education on health.

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