"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Friday, 7 September 2012

Independent

What is the point of being "independent" on a committee? Surely it is so that you can use your abilities, expertise and knowledge to form your opinions, rather than to simply parrot the opinions of the people who have appointed you?

The Future Forum is described as "independent". It isn't. It is appointed. Nick Timmins "Never Again" says
[Prof Steve Field said that Sir David] Nicholson told him "that the chancellor, the prime minister and the deputy prime minister had met and decided that because of the reaction in Sheffield and the noise in the system, they wanted to get a better understanding of what the problems were. He told me my name had been discussed about potentially chairing this Future Forum and that they were going to make a decision, but if I was asked by the minister would I do it?" He [Prof Field] said yes and was told to expect a call from Number 10, while the department worked hard on assembling names for four working groups
The Department of Health "worked hard on assembling the names" of the four working groups of the Future Forum meaning that they appointed the forum. Timmins goes on:
Finally on a train back to his home in Birmingham a call came through from Simon Burns, on behalf of Cameron and Lansley, formally asking him [Field] to chair the new Forum.
Hence Field was asked by Burns on behalf of Cameron and Lansley to be the Chair of the Future Forum.

The Future Forum (FF) is a committee appointed by the Department of Health. Even if the FF was not told what to think (and I have doubts about that) it is clear that the composition of the forum is important and if the department chose people that agree with the thinking behind the bill they would provide a report that agreed with that thinking. It is a classic move that could have been a plot line of Yes Minister: need an "independent" report that agrees with you? so appoint a committee of people who agree with you to write it and tell them they are "independent". The FF report only made cosmetic changes to the Bill.

Now we are told that Prof Field has been appointed to the National Commissioning Board as Deputy National Medical Director. But he is still the Chair of the "independent" Future Forum. How can the FF be independent when the Chair is Deputy National Medical Director?

What about NICE (the National Institute for Health and Clinical Excellence)? Its website says:
We provide independent, authoritative and evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health, reducing inequalities and variation.
NICE evaluates drugs and treatments, it uses evidence from peer reviewed papers to determine how effective the drug or treatment is. It is vital to the finances of the NHS that the service uses only those drugs that have been shown to be effective. The problem is that drug companies hate NICE. They hate NICE because the drug companies spend large amounts of money to create public demand for ineffective drugs which are then rejected by NICE.

It is vital that the experts who make the decisions on behalf of NICE are independent, they have a very difficult and important job to do. But now that independence is under threat, the following article is from Pulse:
Pulse has learnt that the Department of Health is set to table secondary legislation under the Health and Social Care Act so that the health secretary will personally approve all appointments to the panel of experts that consider appeals from drugs companies against NICE appraisals of drugs. The chair of the appraisal appeal panel will also have to be 'someone from outside NICE'.
Apparently, the Association of the British Pharmaceutical Industry wrote to Lansley and told him "Policy is made a long way from political accountability and the NICE Executive appears to have no remit or desire to challenge the decisions of independent academics." They were complaining that decisions were being made by independent academics! In the future the appeal panel members will have to be approved by the Secretary of State for Health (the completely, and totally incorruptible Jeremy Hunt someone who would never be influenced by large multinational companies).

If the 18th Century British politicians were anything like the current government it is no wonder that they fought a revolution to gain their independence.

1 comment: