Over 5,000 jobs are to go as plans are outlined to cut the number of NHS arm’s length bodies (ALBs).

The review of ALBs (or quangos according to BBC news) was announced at the Health Select Committee by the Health Secretary last October. The review has discovered that:

• there are too many overlapping and duplicated functions
• there are too many unnecessary regulatory and policy activities
• back office functions such as human resources, finance, IT and estates could be rationalised
• numerous bodies could be merged, reducing overheads and integrating similar functions
• some bodies could be given independent status, with greater stakeholder control

In response, John Reid has set the following targets for 2007/08:

• 50 per cent reduction in the number of ALBs
• saving in expenditure of £0.5bn
• reduction in posts of 25 per cent

‘In a full year, ALBs spend more than £2.5bn and employ more than 22,000 staff.’ The Health Secretary said. ‘If left unchanged, they would employ about 10 times the number of staff of the Department itself after completion of its change programme.’

‘Changes on this scale will enable considerable extra resources to be redeployed to the frontline. For example another £0.5bn would provide for four new hospitals, or 20,000 more nurses, or 6,250 consultants, or 7,500 general practitioners.’

The list of ALBs includes some of the main NHS bodies, such as the Healthcare Commission, the Medicines and Healthcare Products Regulatory Agency, the National Blood Authority, the National Institute for Clinical Excellence, NHS Direct and the Prescription Pricing Authority. A definitive list of the 21 organisations to be scrapped will be revealed in June.

Arm’s length bodies

• Commission for Patient and Public Involvement in Health (CPPIH)
• Commission for Social Care Inspection (CSCI)
• Council for the Regulation of Healthcare Professionals (CRHP)
• Dental Vocational Training Authority (DVTA)
• Family Health Services Appeals Authority (FHSAA)
• General Social Care Council (GSCC)
• Healthcare Commission (HC)
• Health Development Agency (HAD)
• Health Protection Agency (HPA)
• Human Fertilisation and Embryology Authority (HFEA)
• Medicines and Healthcare Products Regulatory Agency (MHRA)
• National Biological Standards Board (NBSB)
• National Blood Authority (NBA)
• National Clinical Assessment Authority (NCAA)
• National Institute for Clinical Excellence (NICE)
• National Patients Safety Agency (NPSA)
• National Treatment Agency for Substance Misuse (NTA)
• NHS Appointments Commission (NHS AC)
• NHS Counter Fraud and Security Management Service (NHS CFSMS)
• NHS Direct
• NHS Estates
• NHS Information Authority (NHS IA)
• NHS Litigation Authority (NHS LA)
• NHS Logistics Authority
• NHS Modernisation Agency
• NHS Pensions Agency (NHS PA)
• NHS Professionals
• NHS Purchasing and Supplies Authority (NHS PASA)
• NHS University
• Office of the Independent Regulator of NHS Foundation Trusts (OIR)
• Postgraduate Medical Education and Training Board (PMETB)
• Prescription Pricing Authority (PPA)
• UK Transplant (UKT)

The vast sums and effort ploughed into the NHS seem to have improved the service according to health professionals and patient representatives.

The good news comes in Caring in many ways, the annual report of the NHS Modernisation Board. It attributes the improvements to waiting times, accessibility and new developments to changes of attitude and culture brought in by the NHS Plan.

There is, however, still much to do, according to the report, which covers March 2003 to March 2004. The NHS still needs to continue on its mission for patient-centred care by providing more convenient local services.

NHS Modernisation Board member Dr Jenny Simpson said: 'Patient surveys indicate high levels of satisfaction with services even though the public in general continues to be sceptical.'

Health Secretary John Reid said: 'I asked the Modernisation Board to examine the NHS through patients' eyes, witnessing how they experience care, treatment and support first hand.'

The number of delayed discharges from hospitals has fallen by just over 4,000 since 2001. The success has been put down to investment in social care (cash for change programme) and the use of remibursement costs.

Health Secretary John Reid welcomed the latest figures, claiming:

‘Those 4,000 extra free beds are the equivalent of adding eight typical district general hospitals to the NHS — helping us speed up treatment for those who need it.’

New rules were introduced in January whereby the NHS is reimbursed by the local authority for any delays in hospital discharge if the council fail to provide the necessary assessments or services for a patient. This system was introduced in shadow form last October. Reimbursement payments to the NHS are set at £100 a day for most of England and £120 a day for London and the south east, to reflect the varying costs of care.

* provisional data

Health minister John Hutton has announced the creation of eight new treatment centres across England, to be operated by Capio Healthcare UK.

The majority of staff working in the new treatment centres will be additional to the NHS and perform general surgery, trauma and orthopaedics operations.

Hutton said: ‘I am determined that no NHS patient should wait in pain where we can negotiate good value agreements with the independent sector. This agreement with Capio will provide the operations well below the current rates being charged in the private sector.’

It is expected that the centres will treat their first patients in March 2005.

Expectant mothers across Wales should consider home birth an option, according to Health Minister Jane Hutt.

A new leaflet published today, Home sweet home: thinking about home birth answers common questions such as:

• Why home birth?
• Who is suitable?
• Who needs to be there?

Heads of midwifery have set a 10 per cent homebirth rate by 2007, and this publication is seen as a step towards this target.

Jane Hutt commented: 'We know that women want a safe place to give birth in an environment where they feel comfortable and as relaxed as they can be. For many women this is home… If we all work together to offer real choice and support to women who choose home birth I am confident that home birth rates will continue to increase.'

She praised the all-Wales home birth reference group for its work in supporting this initiative throughout Wales. This group produced the leaflet, supported by Bounty, the organisation which supplies packs of advice and samples to expectant and new mothers, and the heads of midwifery.