Published:25/04/2002, Volume II2, No. 5802, Page 4 5

Chair of the Commission for Health Improvement Dame Deirdre Hine is to resign, amid speculation she is unhappy about a policy shift away from quality improvement towards the tougher approach adopted by bodies like education watchdog Ofsted.

Dame Deirdre announced this week that she will retire in October, at the end of her three-year term as chair, and well before CHI becomes part of the new, larger and more powerful Commission for Healthcare Audit and Inspection announced by health secretary Alan Milburn last Thursday.

HSJ sources believed the former chief medical officer of Wales had become disillusioned with Mr Milburn's desire to toughen up CHI and give it 'an edge'. Dame Deirdre had often outlined her commitment to the 'developmental' approach to the quality agenda.

However, when HSJ asked if Dame Deirdre was resigning on principle because she was unhappy about the direction CHI is taking, a spokesperson said the CHI chair rejected the claim 'outright'.

HSJ was given a statement from Dame Deirdre which said: 'I am delighted the government recognises explicit independence is so important for the new organisation. I am also pleased CHAI will encompass the private sector. It is important that, although the new commission will have additional responsibility for reviewing the financial elements of the NHS, emphasis on quality of patient care and the patient experience should still be central to the work it does.'

The official statement issued to the press quoted Dame Deirdre saying: 'The creation of [CHAI] is a great endorsement of CHI's work. Leading the transitional arrangements will be a major project and I feel the end of my current term of office is a proper time to allow someone else the task of leading the organisation.'

Days before CHI confirmed Dame Deirdre's departure, HSJ sources said she was considering her future. One well placed NHS source claimed Dame Deirdre's departure was partially due to her disillusionment about the change in CHI's role, but also to her awareness Mr Milburn might be looking for a different kind of approach.

A senior government source suggested Mr Milburn had been waiting to give CHI a more abrasive management style since its creation.As health minister under then health secretary Frank Dobson, Mr Milburn wrote the white paper The New NHS which laid out the framework for CHI in 1997. But two years later, when the senior appointments were made, Mr Milburn had been shifted to the Treasury. Both HSJ 's sources suggested the appointments made in his nine-month absence were not necessarily those he would have made.

'What Mr Milburn wanted was an Ofsted with leadership of the Chris Woodhead variety, with criticisms levelled at the providers.

The developmental side has been hived off to the Modernisation Agency. The question is to what extent the developmental agenda will be allowed to move on or whether it will be moved out, ' HSJ's government's source added.

At the press conference outlining the changes, Mr Milburn was asked if he thought CHAI would be led by a figure like Mr Woodhead. He said: 'It is up to the commission... they will determine the matter of the individual required. But he stressed: 'It is important this commission has an edge.'

CHI said their chief executive Dr Peter Homa intends to apply for the job of chief inspector of healthcare, running CHAI. But one source said Professor Sir Ian Kennedy, chair of the Bristol inquiry, also stands a good chance.

One of the main recommendations of the Kennedy report, published last July, was for CHI to take on extra powers and be placed at arm's length from government.

At the start of this year, Sir Ian resigned from his post as professor of health law, ethics and policy at University College London. He said at the time: 'I've got to find a job.'One HSJ source said this week:

'The NHS owes him after Bristol.'