Andrew Lansley, the health secretary, today announced a cull of regulators to save £180m in the health sector – consigning the agency that handles public health emergencies to oblivion and splitting up the fertility watchdog. Lansley said the aim was to save costs and cut bureaucracy in the NHS and that "essential" work would be moved to other bodies. The department stated that "the changes outlined in today's report will reduce the number of health ALBs (arm's-length bodies) from eighteen to between eight and ten; they are expected to deliver savings of over £180m by 2014/15". The report gives does not say how many jobs will go.
The shakeup will see high-profile casualties. The Health Protection Agency, which has been responsible for responding to public health hazards such as bird flu and swine flu since 2003, will be subsumed into a new Public Health Service. Also going is the National Patient Safety Agency – its main remit will go into a new NHS commissioning board while its research and ethics functions will move elsewhere. By the end of the current parliament, the Human Fertilisation and Embryology Authority will be dismembered and its roles taken up by a new research regulator, the Care Quality Commission, and the Health and Social Care Information Centre.
During the election the Conservatives pledged to light a 'bonfire of quangos' and make ministers and NHS staff accountable for decisions by removing bureaucracy. Lansley said: "Over the years the sector has grown to the point where overlap between organisations and duplication of effort have produced a needless bureaucratic web. By making sure that the right functions are being carried out at the appropriate level, we will free up significant savings to support front-line NHS services."
However some commentators were caustic about the new "market driven NHS". The review says "where appropriate, arm's-length bodies will be expected to exploit commercial opportunities and maximise commercial discipline across the sector". Andy Cowper of the Health Policy Insight blog remarked: "And in our brave new world, the work of ALBs is going to be a money-spinner. No, really."
Although there have been warnings that patient safety may be compromised, not all the changes will be controversial. The National Treatment Agency for Substance Misuse and Alcohol Education was heavily criticised by Lansley's cabinet colleague Iain Duncan Smith for spending billions of pounds on schemes with little evidence they worked. The agency has seen a 50% increase in funding – to £1.2bn – but reported a success rate of 4.3%, which translates as just 1 in 23 people 'in treatment' quitting drugs.
