Less emphasis on the use of the private sector and a slow-down in market-based reforms could be the hallmark of Gordon Brown's premiership for the NHS, according to health experts.

Leading health service academics and commentators have told HSJ that Mr Brown is expected to soft-pedal on use of the independent sector in the health service when he becomes prime minister next month.

Former health adviser to Tony Blair and London School of Economics professor of social policy Julian Le Grand said he thought it was doubtful that another wave of independent sector treatment centres would be commissioned when Mr Brown takes office.

'I think Mr Brown will still be committed to some degree of contestability, but he is not absolutely sure about market-driven reforms,' he said.

'He has sympathy with the US way of doing things, but is aware of the problems involved in introducing markets and quasi-markets into healthcare.'

'More pragmatic'

And former Department of Health strategy director Professor Chris Ham said: 'Mr Brown will be a lot more pragmatic about a bigger role for the independent sector.

'Tony Blair did it because he thought it was the right thing to do, I think Gordon Brown will see it not so much as an end itself but will be persuaded by a greater role for the independent sector if it can show innovation or deliver shorter waiting times.'

Institute for Public Policy Research head of health and social care Jessica Allen said: 'I wouldn't expect a great expansion in the use of the independent sector. I don't think there is any sense he will abandon the use of the private sector completely, but we will see it used where there are gaps in services.

'I think he might have less confidence that the health sector operates in the same way as other sectors, where efficiencies will arise from having a greater market.'

And King's Fund chief economist Professor John Appleby said the treasury, with Mr Brown at the helm, had expressed 'scepticism in an oblique way', about how far the use of the independent sector to increase choice could improve quality of services within the NHS.

Independent NHS board

Before Mr Blair announced details of his resignation, Mr Brown was widely believed to be preparing the ground for an announcement to match his decision to free the Bank of England from government control.

He was expected to introduce an independent NHS board in his first few days at Number 10, but Professor Ham said he now seems more cautious about such a move.

'I would say there is a strong argument for distancing politicians from the NHS and it would perhaps be sensible to start with something modest, like further separating NHS chief executive David Nicholson's team from the DoH and use that as a staging post for something more radical,' he said.

Professor Appleby said he was unsure that Mr Brown would announce a fully blown NHS board.

'Rhetorically it looks appealing for the government to show that they are not interfering, but they have gone a long way down that route already with payment by results and foundation trusts,' he said.

Launching his campaign to become leader of the Labour Party, Mr Brown stressed how important greater access to health services would be under his leadership.

Professor Ham said he expected the man who commissioned the Wanless report to make public health a major priority.

Flagship ISTC comes back to the NHS fold

One of the government's flagship independent sector treatment centres will be taken over by Surrey and Sussex Healthcare trust at the end of the year.

As HSJ went to press, trust chief executive Gail Wannell said the trust felt 'the time was right'.

She added that the decision had been made following an extensive review of the contract.

The Redwood centre has been run by Bupa for the last five years and was one of the Department of Health's first attempts to bring private sector provision to NHS patients. Its primary aim was to reduce the trust's then 18-month waiting time for elective general surgery.

Bupa Hospitals' managing director Clare Hollingsworth said: 'We are naturally very disappointed by this decision by the trust board.'