Politicians of all hues cannot resist temptation to favour party faithful

Ten years ago this week a furious political row broke out about the NHS: Labour accused the Conservative government of grotesque party bias when appointing health authority chairs.

Now a similar row is brewing - except that this time Labour is about to be accused of favouring its own when appointing NHS non-executive directors.

In 1990 the then shadow health secretary, Robin Cook, claimed that in North Thames alone three out of four new chairs were Conservative councillors and after the latest round of appointments only four Labour figures remained in the whole region. Next week public appointments commissioner Dame Rennie Fritchie will reveal what are rumoured to be damning findings from her inquiry into non-executive appointments since Labour came to power three years ago.

Could there be a more vivid example of how the NHS suffers from being - in that time-honoured sobriquet - a 'political football'? Whoever is in power, you can predict that they will seek to pack health service boards with their political allies; the NHS is too crucial and high-profile a public preoccupation for any politician to resist the temptation. Equally, you can predict that the party excluded from power will react with shrill indignation.

Soon after Labour was elected the then health secretary, Frank Dobson, made no secret of his wish to clear out what he described as the 'dead wood' among non-executives who had been appointed by the previous government. A gung-ho spirit of 'We're the masters now' prevailed in 1997, and on the strength of it the political complexion of NHS boards was changed markedly. By 1998 Labour supporters outnumbered Conservatives by 9.6 to 3.9 per cent. A year later Conservative non-executives had grown to 5.4 per cent - but Labour ones numbered 20 per cent.

Of course it is reasonable for a government to expect that those charged with running the service are broadly in sympathy with its policy. But ultimately it is not party affiliation which is important but calibre. Clearly, it is not acceptable to assume that party membership can be taken as a proxy for management ability. When the appointees of one party vastly outnumber those of others, it looks suspiciously as if one or both of these guiding principles is being breeched. Dame Rennie will have the definitive answer.

The solution is to take non-executive appointments out of the hands of the secretary of state and give them either to an independent commissioner or perhaps to a Commons select committee.

The public demands much more transparency in such processes than currently exists. Without it non-executives will be regarded with cynicism, and the already limited legitimacy they enjoy in making decisions critical for whole communities will be eroded further.