comment: Change of status underlines importance of Modernisation Agency

Published: 20/03/2003, Volume II3, No. 5847 Page 17

When HSJ conducted its reader research late last year, 11 per cent of respondents identified 'the influence of the Modernisation Agency' as one of the three most important issues in their working lives over the next three years. Its work is thought more significant than headline topics such as the GP contract, staff recruitment and patient choice. Even national targets scored only 19 per cent.

It is significant, therefore, that the agency is at last to get the status that befits its name.

Making it an executive agency is a vote of confidence in the agency and in director David Fillingham's stewardship. His review last year of the agency's operations, which will result in much modernisation work being devolved to local level, was seen as a canny reading of the need to decentralise - and quickly. When the rest of the Department of Health reached the same conclusion a few months later, the idea of rewarding the agency with a executive status - and the financial and managerial freedoms that go with it - was rapidly born.

Despite apparently giving away some of its resources, the agency has become more bullish - and potentially more influential. This was apparent at last week's HSJ conference. Mr Fillingham made it clear that the agency was determined to demonstrate how modernisation can have a wide impact - on public health, value for money, quality of care and job satisfaction (news, page 8-9). There were signs of newfound independence, too, with redesign director Helen Bevan remarking on the irony of fining social service departments for delayed discharges while trusts still suffer from endemic, unnecessary inefficiency (news, page 10-11).

But do not expect the agency to go native. It will remain keen to stay close to ministers and vice versa - devolution is all very well, but in a state-run organisation like the NHS staying close to the source of policy and funding is sensible.

At the end of his speech, Mr Fillingham said that the agency must make modernisation real to a much wider spectrum of NHS staff. He is right. Whether it succeeds or not, it seems likely that the Modernisation Agency will remain a force within the NHS for the foreseeable future.