EXCLUSIVE Provision and commissioning to split as top civil servants' 'fitness' is reviewed

Published: 15/12/2005 Volume 115 No. 5986 Page 7

The Department of Health looks set to be split into two, with one side covering the provision of services and the other commissioning.

NHS chief executive Sir Nigel Crisp's role could be split into two along the same lines, while the NHS top team will be reviewed to see who is fit for the new roles.

The plans have been put forward by management consultants brought in by health secretary Patricia Hewitt to shake up the DoH.

Consultants from McKinsey have been at Richmond House all week interviewing senior DoH managers.

Their remit is to decide whether the department is fit for the future challenges and whether it has the right skillset.

An insider said: 'It is a no-holds bars look at the top team to see if they are fit for the future. They are looking at radical solutions. Questions should be asked by all parts of the NHS all the time, from the top downwards.' The report is expected early in the new year and major changes 'are expected'.

On the DoH website, Sir Nigel said: 'I am very keen to ensure the department can sustain delivery and develop and implement major system reforms in the period to 2008.

'Just as we are instituting fitness for purpose assessments for NHS organisations for their future role, I am commissioning a quick review of the top structure of the department to make sure we can play our part effectively in the future.'

Hewitt rejects NHS 'market' accusations

The NHS is not being turned into a market - but a 'modern public service', health secretary Patricia Hewitt argued in a London School of Economics lecture on Tuesday.

Ms Hewitt defended current reforms but insisted they did not amount to a market in healthcare: 'Why should the use of the private sector, when it gives us new hospitals and benefits patients, have to mean privatisation?

'What we are creating - not only in health and social care, but in education and many other public goods - are not markets, but modern public services.' . As HSJ went to press, the DoH published a paper on health reform by head of strategy Bill McCarthy.