Ministers to vet local NHS appointments: Move aims to sharpen purchasing skills

HEALTH ministers are planning to vet appointments to District Health Authorities and Family Health Service Authorities in the next stage of the Government's fundamental changes to the National Health Service.

Brian Mawhinney, Minister of State for Health, has reached a voluntary agreement with regional health committee chairmen to ensure that he is consulted when all new appointments to the bodies are made.

'We are not talking about wholesale changes but we need to get into the DHAs and FHSAs people who have purchasing experience,' Dr Mawhinney said.

He is leading a government campaign to sharpen the purchasing powers of the DHAs and FHSAs to force the providers - the NHS trust hospitals - to improve their services. It will include innovative ideas such as paying hospital consultants to conduct more clinics in GP surgeries and using more private- sector expertise in purchasing.

Dr Mawhinney said: 'It will provide more flexibility for patients, more change, and that will be designed to get more patients treated with better quality of outcome.'

Labour, however, suspects the move is part of a pattern of putting more Tory supporters and sympathisers in key NHS positions. David Blunkett, Labour's health spokesman, said the Conservatives cut the automatic seats on DHAs for local councillors when they changed the authorities in the Eighties.

He said: 'They are already business-orientated. Tightening up that change would remove even the last vestiges of non- commercial, non-Conservative elements. It would be very bad news because it fails to recognise that health care is a service and not a commercial business. Many of the businessmen appointed to these bodies have failed in their own businesses.'

Mr Blunkett is preparing a detailed dossier on the Tory bias in the appointments made in the NHS since the changes were introduced. A preliminary study showed that 71 per cent of non- executive appointments to some hospital trust management executives had affiliations to the Conservative Party.

Meanwhile, Dr Sandy Macara, the new chairman of the British Medical Association, said in an interview with a Sunday newspaper yesterday that the NHS was 'disintegrating', and the main patients' watchdog group says today that a less open style of management means that a growing number of decisions about care and treatment are being made away from public scrutiny.

Health authorities and trust boards have cut back on public meetings and fund-holding GP practices are reluctant to reveal purchasing plans, the Association of Community Health Councils for England and Wales says in its annual report.

Almost two-thirds of health authorities now meet between four and six times a year, compared with 10 to 12 times before the NHS changes, it says. Trust hospitals show a similar trend. 'Many decisions are made outside formal meetings and therefore away from public view,' the report says.