Ministers have come close to admitting that asking MPs to recommend people to sit on hospital or health authority boards can 'politicise' the NHS.
In a long-delayed response to damning charges from the public appointments watchdog that Labour filled NHS boards with its cronies, ministers have agreed to reduce the influence of MPs.
But the government has staved off demands to loosen its grip on appointments to trusts by giving HAs power to fill the posts. Decisions on many of the recommendations in a highly critical report from public appointments commissioner Dame Rennie Fritchie will be included in the national plan, due later this month. However, ministers have already rejected Dame Rennie's call to stop council leaders having the power to nominate representatives for non-executive HA and trust posts.
But they have given way on the issue of involving MPs. In a letter to Dame Rennie, junior health minister Gisela Stuart said parliamentarians would no longer be asked to comment on the shortlist for chair appointments: 'This practice dated from the previous government, and although we believe it provided useful input it is evident that it has been perceived as politicising the process.' MPs will still be able to nominate candidates.
Dame Rennie's report, in March, suggested that Labour activists had been chosen for NHS boards for their party allegiance. Appointments 'have not always been made on merit, ' she said.
'Moreover, I would go further and conclude that the process has become politicised in a systemic way.'
But ministers have stood firm against many of her conclusions. They have refused to commission a review of the role and purpose of NHS boards, referring instead to a 1999 'joint understanding' with the NHS Confederation and Department of Health.
They have rejected a call to draw up 'fresh job descriptions' for chairs and non-executives, insisting the current versions 'have been satisfactory'.
The government insists it will still ask councils to nominate members of NHS boards, despite Dame Rennie's call for the practice to stop.' We do not agree', Ms Stuart told the commissioner: 'Local authorities have valuable knowledge about the local community and its healthcare needs.'
Some managers backed the government. Dr Ian Greatorex, chief executive of Salford and Trafford HA, said: 'There is no reason why local authorities should not be able to nominate members of local quangos, but where you have one party dominating an area that does give rise to accusations of bias.'
Dr Greatorex welcomed the move to reduce the influence of MPs. Les Howell, former chief executive of Preston's Guild trust, warned against giving HAs power to appoint to trust boards, saying it would 'undermine' independence.
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