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Healthcare provision in the NHS should be decentralised and public private partnerships should go beyond ideas laid out in the NHS plan, according to a study by the Institute of Directors. Its healthcare provision policy study group argues that healthcare services funded by the NHS should be taken out of direct state control in a bid to achieve the government's idea of 'earned autonomy'. But it also calls for greater management accountability. Head of policy Ruth Lea said: 'On grounds of efficiency and good governance alone, serious consideration should be given to publicly funded NHS bodies, such as hospital and primary care trusts, becoming truly selfgoverning bodies. The NHS...is far too big to try to run centrally.'