The health secretary will "franchise" the running of the NHS to a quango for up to three years at a time – a move that will result in an unelected academic and the nation's 38,000 family doctors, rather than ministers, being accountable for the day-to-day running of the health service, according to leaked documents obtained by the Guardian.
In unpublished evidence to the health select committee last week, Malcolm Grant, the government's choice to run the powerful NHS commissioning board, outlined "an extraordinary transformation of responsibility" that appears to undermine claims by ministers that the proposed legislation will not dilute the government's constitutional responsibilities to the health service.
At present, the cabinet minister for health has a "duty to provide a national health service" in England, but that disappears in the NHS bill's proposals.
Grant, a law professor who runs University College London, told MPs that, under the new system, the secretary of state "mandates" the commissioning board to run the NHS every "two … possibly three years" and then retreats into the shadows. The board will hand over taxpayers' cash to groups of GPs to buy services on behalf of patients.
http://www.guardian.co.uk/society/2011/oct/23/nhs-power-held-by-quango