The government is preparing an attempt to depoliticise the National Health Service by passing key decisions about hospital mergers and bed places to an independent panel of doctors, nurses, managers and patient representatives. Alan Milburn, the health secretary, is expected to announce today that ministers will accept recommendations from this new national hospital beds panel in all but exceptional circumstances.
He regards the move as a decentralisation of power similar to Gordon Brown's decision in 1997 to devolve control of interest rates to the Bank of England's monetary policy committee.
The scheme will be outlined by Mr Milburn in a speech to the NHS Confederation in Glasgow, preparing the way for publication of a new national plan for the health service at the end of next month.
The independent panel will be "tasked with ensuring the NHS achieves ministers' commitment for delivering more beds in the whole care system".
Downing Street sources said ministers were determined to get rid of procedures that contributed to the NHS losing 40,000 hospital beds between 1987 and 1997.
Frequently proposals for hospital closures, mergers and reorganisations encountered local objections and were referred to Whitehall for resolution.
Over the years decisions were taken on individual applications without an effective check on regional bed supply for patients in hospital and social care.
"We have had a patchwork of decisions with no national co-ordination," the source said. "The budget and radical NHS reforms in the national plan will go a long way to delivering Alan Milburn's commitment to provide more beds in the health care system."
The independent beds panel will make recommendations on all proposals for hospital reorganisations. Although it will be expected to follow government health policies and work within budgets set by the Treasury, it will be told to act independently of ministers. A third of the panel will be made up of doctors, nurses and representatives of the royal colleges. A third will be representatives of patients, and a third of high achieving health service managers.
"The panel will make recommendations to approve or reject mergers or reorganisations. The secretary of state will accept recommendations in all but most exception circumstances," the source said.
Government plans to introduce performance incentives for staff in the NHS received unexpected backing yesterday from health service managers.
Ministers want to offer extra rewards for staff achieving productivity targets, but have run into stiff resistance from doctors' and nurses' leaders.
The first encouragement for ministers to include performance incentives in the forthcoming national health plan came in a poll of about 1,000 senior managers and trust representatives at the NHS Confederation conference. About 80% supported non-pay incentives as a way of motivating staff to perform better and 69% approved of financial bonuses to reward groups of staff who were performing well. There was less support for individual pay incentives, with 45% backing performance-related pay similar to the scheme being introduced for teachers.
But the decision by nearly half the managers to entertain this idea astonished leaders of the NHS Confederation, who have been arguing against any form of financial incentives. Andrew Foster, the confederation's policy director, said staff were opposed to rewards that might bring pecuniary benefit to themselves at the expense of patient care. Experimental team bonuses to reduce sickness absence resulted in staff coming to work when they were ill.
The confederation is urging the government to stick to non-pay incentives that would offer extra training, amenities and equipment to successful health service teams. Neil McKay, NHS deputy chief executive, told the conference that new incentives were needed "at every level" for organisations, individuals and teams.
