Department of Health (United Kingdom)
Encyclopedia
The Department of Health (DH) is a department of the United Kingdom government
with responsibility for government policy for health
and social care matters and for the National Health Service
(NHS) in England
along with a few elements of the same matters which are not otherwise devolved to the Scottish, Welsh
or Northern Irish
governments. It is led by the Secretary of State for Health
with two Ministers of State
and two Parliamentary Under-Secretaries of State
.
The role that the department of health plays is a role of overall introducing policies and guidelines which then improve the quality of care and they also help meet patient’s standards.
The DH carries out some of its work through arm's length bodies, including non-departmental public bodies and executive agencies
such as the Commercial Medicines Unit (CMU) and the Medicines and Healthcare products Regulatory Agency
(MHRA).
Like many others, the department with responsibility for the nation's health has had different names and included other functions over time.
In the 19th century, several bodies were formed for specific consultative duties and dissolved when they were no longer required. There were two incarnations of the Board of Health (in 1805 and 1831) and a General Board of Health (1854 to 1858) that reported directly into the Privy Council. Responsibility for health issues was also at times, and in part, vested in local health boards
and, with the emergence of modern local government, with the Local Government Act Office, part of the Home Office. In the early part of the 20th century, medical assistance was provided through National Health Insurance Commissions.
The first body which could be called a department of government was the Ministry of Health, created in 1919 through the Ministry of Health Act, consolidating under a single authority the medical and public health functions of central government. The co-ordination of local medical services was expanded in connection with emergency and wartime services, from 1935 to 1945, and these developments culminated in the establishment of the NHS
in 1948.
In 1968, the Ministry of Health was dissolved and its functions transferred (along with those of the similarly dissolved Ministry of Social Security) to the newly created Department of Health and Social Security
(DHSS). Twenty years later, these functions were split back into two government departments, forming the Department of Social Security
(DSS) and the current Department of Health.
's expression of disdain "D'oh!
". DH is now the abbreviation used in correspondence, official email addresses and URLs, although a number of health media outlets continue to favour the previous abbreviation.
(Whitehall
, London
). Other London locations include Skipton House
(Elephant and Castle
), Wellington House near Waterloo station
and New King's Beam House near Blackfriars Bridge
. Alexander Fleming House and Hannibal House
were previously used by the department. In addition, staff are based in Quarry House
in Leeds
,
at the Department of Health is Una O'Brien. Following the resignation of the previous Permanent Secretary Sir Nigel Crisp in March 2006 a separate post of Chief Executive of the NHS has been recreated, this is held by David Nicholson.
Previous permanent secretaries:
. The Chief Medical Officer and Chief Nursing Officer are also directors of the department's board.
bacteria
("superbugs"), such as Methicillin-resistant Staphylococcus aureus
(MRSA) and Clostridium difficile
, in NHS hospitals has led to criticism of the DH's decision to outsource cleaning via private finance initiative
contracts as "cutting corners on cleaning".
A "Deep Clean" initiative announced by the Department of Health was criticised by infection control experts and by the Lancet as a gimmick which failed to address the causes of in-hospital infections, by the firms doing the work as an attempt to avoid paying for regular better cleaning, and by NHS managers as ineffective.
It also attracted criticism because only a quarter of the £60m funding for the scheme actually went to hospitals, and because a number of hospitals missed the completion target, and as of June 2008 one in four NHS trusts was not meeting the government's standards on hygiene.
, in particular in the changes it made to the specialist training of doctors and the Medical Training Application Service
(MTAS). These changes left "29,193 junior doctors from the UK and overseas... chasing 15,600 posts..." and resulted in accusations that the DH had broken the law by refusing to reveal scores to candidates. Ultimately there was a judicial review
and a boycott of the system by senior doctors across the country. MTAS was eventually scrapped and Patricia Hewitt
, the then Secretary of State for Health, resigned following accusations that she had lied to the House of Commons over the system. Even after the abolition of MTAS, anger among the medical profession continued, with the British Medical Association
commenting of the DH response that "Not only is this response too late, it does not go far enough".
The official government inquiry into MMC
recommended that the responsibility for medical training be removed from the DH.
In September 2008 a new leadership team was established, CIO for Health, Christine Connelly, and director of programme and system delivery Martin Bellamy. Previous CIO Richard Granger was believed to have been the most highly paid civil servant in the UK and was a controversial figure. Connelly left the DoH for a position in the Cabinet Office in June 2009 and was replaced by Tim Donohoe and Carol Clarke.
Connelly's role is to "deliver the Department's overall information strategy and integrating leadership across the NHS", according to the DoH's website. That strategy, known as the National Programme for IT, is intended to do nothing less than revolutionise NHS information workflow and is costed at about £12.7bn. The success or otherwise of Connelly's reign will be based on her promise to end delays of electronic medical records. She has said that if there is not clear progress by November 2009, a new plan could be hatched.
On the eve of the departure of Fujitsu as an outsourcing partner, Connelly said in April 2009 that she would open up sourcing to competition at "acute" sights in the south of England and offer toolkits by March 2010 to allow more local configuration of systems.
In January 2009, MPs criticised DH for its confidentiality agreement with key supplier CSC and in March the Department was admonished by the Information Commissioner for its records management. In May 2011, Prime Minister David Cameron announced that he was considering scrapping the project.
(IAPT) and the withdrawal of the practical assistance available to the NHS and local authorities via the National Support Teams
.
A number of health issues are, however, wholly or partly reserved to Westminster:
Scotland
Northern Ireland
In Northern Ireland, abortion
law is a criminal justice matter and is devolved.
Wales
Under the Welsh devolution settlement, specific policy areas are transferred to the National Assembly for Wales
rather than reserved to Westminster. As the distinction between Government and actual health services is seen as less pronounced than in England, the main source of information about current developments is NHS Wales.
Departments of the United Kingdom Government
Her Majesty's Government of the United Kingdom contains a number of Cabinet ministers who are usually called secretaries of state when they are in charge of Government departments called ministerial departments...
with responsibility for government policy for health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
and social care matters and for the National Health Service
National Health Service (England)
The National Health Service or NHS is the publicly funded healthcare system in England. It is both the largest and oldest single-payer healthcare system in the world. It is able to function in the way that it does because it is primarily funded through the general taxation system, similar to how...
(NHS) in England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
along with a few elements of the same matters which are not otherwise devolved to the Scottish, Welsh
Welsh Assembly Government
The Welsh Government is the devolved government of Wales. It is accountable to the National Assembly for Wales, the legislature which represents the interests of the people of Wales and makes laws for Wales...
or Northern Irish
Northern Ireland Assembly
The Northern Ireland Assembly is the devolved legislature of Northern Ireland. It has power to legislate in a wide range of areas that are not explicitly reserved to the Parliament of the United Kingdom, and to appoint the Northern Ireland Executive...
governments. It is led by the Secretary of State for Health
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...
with two Ministers of State
Minister of State
Minister of State is a title borne by politicians or officials in certain countries governed under a parliamentary system. In some countries a "minister of state" is a junior minister, who is assigned to assist a specific cabinet minister...
and two Parliamentary Under-Secretaries of State
Parliamentary Under-Secretary of State
A Parliamentary Under-Secretary of State is the lowest of three tiers of government minister in the government of the United Kingdom, junior to both a Minister of State and a Secretary of State....
.
The role that the department of health plays is a role of overall introducing policies and guidelines which then improve the quality of care and they also help meet patient’s standards.
The DH carries out some of its work through arm's length bodies, including non-departmental public bodies and executive agencies
Executive agency
An executive agency, also known as a next-step agency, is a part of a government department that is treated as managerially and budgetarily separate in order to carry out some part of the executive functions of the United Kingdom government, Scottish Government, Welsh Assembly or Northern Ireland...
such as the Commercial Medicines Unit (CMU) and the Medicines and Healthcare products Regulatory Agency
Medicines and Healthcare products Regulatory Agency
The Medicines and Healthcare products Regulatory Agency is the UK government agency which is responsible for ensuring that medicines and medical devices work and are acceptably safe....
(MHRA).
History
The Department of Health was formally created in 1988, through The Transfer of Functions (Health and Social Security) Order 1988.Like many others, the department with responsibility for the nation's health has had different names and included other functions over time.
In the 19th century, several bodies were formed for specific consultative duties and dissolved when they were no longer required. There were two incarnations of the Board of Health (in 1805 and 1831) and a General Board of Health (1854 to 1858) that reported directly into the Privy Council. Responsibility for health issues was also at times, and in part, vested in local health boards
Local board of health
Local Boards or Local Boards of Health were local authorities in urban areas of England and Wales from 1848 to 1894. They were formed in response to cholera epidemics and were given powers to control sewers, clean the streets, regulate slaughterhouses and ensure the proper supply of water to their...
and, with the emergence of modern local government, with the Local Government Act Office, part of the Home Office. In the early part of the 20th century, medical assistance was provided through National Health Insurance Commissions.
The first body which could be called a department of government was the Ministry of Health, created in 1919 through the Ministry of Health Act, consolidating under a single authority the medical and public health functions of central government. The co-ordination of local medical services was expanded in connection with emergency and wartime services, from 1935 to 1945, and these developments culminated in the establishment of the NHS
National Health Service (England)
The National Health Service or NHS is the publicly funded healthcare system in England. It is both the largest and oldest single-payer healthcare system in the world. It is able to function in the way that it does because it is primarily funded through the general taxation system, similar to how...
in 1948.
In 1968, the Ministry of Health was dissolved and its functions transferred (along with those of the similarly dissolved Ministry of Social Security) to the newly created Department of Health and Social Security
Department of Health and Social Security
The Department of Health and Social Security was a ministry of the British government in existence for twenty years from 1968 until 1988, and was headed by the Secretary of State for Social Services.-History:...
(DHSS). Twenty years later, these functions were split back into two government departments, forming the Department of Social Security
Department of Social Security
The Department of Social Security is the name of a defunct governmental agency in the United Kingdom.The DSS replaced the older Department of Health and Social Security, from 1988 until 2001, when it was itself largely replaced as a department of the Government of the United Kingdom by the...
(DSS) and the current Department of Health.
Abbreviation
Upon de-merger from the DHSS the Department of Health was commonly abbreviated in internal Governmental correspondence to 'DoH', which was also used in staff email address endings (@doh.gsi.gov.uk). This was changed to DH, omitting the 'o', circa 2004, unwritten internal sources suggesting that the original abbreviation may be uncomfortably close to Homer SimpsonHomer Simpson
Homer Jay Simpson is a fictional character in the animated television series The Simpsons and the patriarch of the eponymous family. He is voiced by Dan Castellaneta and first appeared on television, along with the rest of his family, in The Tracey Ullman Show short "Good Night" on April 19, 1987...
's expression of disdain "D'oh!
D'oh!
"D'oh!" is a catchphrase used by the fictional character Homer Simpson, from the long-running American animated sitcom The Simpsons . It is typically used when Homer injures himself, realizes that he has done something stupid, or when something bad has happened or is about to happen to him...
". DH is now the abbreviation used in correspondence, official email addresses and URLs, although a number of health media outlets continue to favour the previous abbreviation.
Location
The official headquarters and ministerial offices are in Richmond HouseRichmond House
Richmond House is the headquarters building of the Department of Health at 79 Whitehall, London, SW1A 2NS. It is where the ministerial team and key officials are based....
(Whitehall
Whitehall
Whitehall is a road in Westminster, in London, England. It is the main artery running north from Parliament Square, towards Charing Cross at the southern end of Trafalgar Square...
, London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
). Other London locations include Skipton House
Skipton House
Skipton House is a high specification office building in Elephant and Castle, Central London.It was built for a Japanese bank and then sold on to accommodate staff of the Department of Health who were moved out of Alexander Fleming House. The project architect was Paul Cayford. Its address is 80...
(Elephant and Castle
Elephant and Castle
The Elephant and Castle is a major road intersection in south London, England, located in the London Borough of Southwark. It is also used as a name for the surrounding area....
), Wellington House near Waterloo station
Waterloo station
Waterloo station, also known as London Waterloo, is a central London railway terminus and London Underground complex. The station is owned and operated by Network Rail and is close to the South Bank of the River Thames, and in Travelcard Zone 1....
and New King's Beam House near Blackfriars Bridge
Blackfriars Bridge
Blackfriars Bridge is a road and foot traffic bridge over the River Thames in London, between Waterloo Bridge and Blackfriars Railway Bridge, carrying the A201 road. The north end is near the Inns of Court and Temple Church, along with Blackfriars station...
. Alexander Fleming House and Hannibal House
Hannibal House
Hannibal House is an icon of 1960s office architecture positioned above the Elephant and Castle shopping centre in Southwark, south London.Until 2005, the building housed various bodies and agencies of the British Department of Health, including the Devices section of the Medicines and Healthcare...
were previously used by the department. In addition, staff are based in Quarry House
Quarry Hill, Leeds
Quarry Hill is an area of central Leeds, West Yorkshire, England. It is surrounded by the Leeds Inner Ring Road to the east and north. The Leeds - York / Hull railway runs just south of the district into the city centre...
in Leeds
Leeds
Leeds is a city and metropolitan borough in West Yorkshire, England. In 2001 Leeds' main urban subdivision had a population of 443,247, while the entire city has a population of 798,800 , making it the 30th-most populous city in the European Union.Leeds is the cultural, financial and commercial...
,
Ministers
The Department of Health Ministers are as follows:| Minister | Rank | Portfolio | |
|---|---|---|---|
| The Rt Hon Andrew Lansley Andrew Lansley Andrew David Lansley, CBE, MP is the UK Secretary of State for Health, who has been the Conservative Member of Parliament for South Cambridgeshire since the 1997 general election, and was Shadow Secretary of State for Health from June 2004 until becoming Secretary of State for Health in May 2010... CBE MP |
Secretary of State Secretary of State for Health Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and... |
Overall responsibility | |
| The Rt Hon Simon Burns Simon Burns Simon Hugh McGuigan Burns is a Conservative Party politician in the United Kingdom. He has been Member of Parliament for Chelmsford since the 1987 general election... MP |
Minister of State | Health services | |
| Paul Burstow Paul Burstow Paul Kenneth Burstow , British politician, is the Liberal Democrat Member of Parliament for Sutton and Cheam. In May 2010 he was appointed Minister of State for the Department of Health.-Early life:... MP |
Minister of State | Care services, mental health, disabilities | |
| Anne Milton Anne Milton Anne Frances Milton is a British Conservative Party politician and former nurse who has been the Member of Parliament for Guildford since 2005. After service on the Health Select Committee, in November 2006 she was appointed Shadow Minister for Tourism. In July 2007 she was appointed Shadow... MP |
Parliamentary Under Secretary of State | Public health, devolved matters | |
| The Earl Howe Frederick Curzon, 7th Earl Howe Frederick Richard Penn Curzon, 7th Earl Howe is a Conservative front bench member of the House of Lords, and is a Parliamentary Under Secretary of State at the Department of Health-Political and professional career:... |
Parliamentary Under Secretary of State | Quality, NHS Constitution, primary care, medicines |
| Key | Conservative Conservative Party (UK) The Conservative Party, formally the Conservative and Unionist Party, is a centre-right political party in the United Kingdom that adheres to the philosophies of conservatism and British unionism. It is the largest political party in the UK, and is currently the largest single party in the House... |
|---|---|
| Liberal Democrat Liberal Democrats The Liberal Democrats are a social liberal political party in the United Kingdom which supports constitutional and electoral reform, progressive taxation, wealth taxation, human rights laws, cultural liberalism, banking reform and civil liberties .The party was formed in 1988 by a merger of the... |
Permanent Secretary
The current Permanent SecretaryPermanent Secretary
The Permanent secretary, in most departments officially titled the permanent under-secretary of state , is the most senior civil servant of a British Government ministry, charged with running the department on a day-to-day basis...
at the Department of Health is Una O'Brien. Following the resignation of the previous Permanent Secretary Sir Nigel Crisp in March 2006 a separate post of Chief Executive of the NHS has been recreated, this is held by David Nicholson.
Previous permanent secretaries:
- Sir Hugh Taylor KCBOrder of the BathThe Most Honourable Order of the Bath is a British order of chivalry founded by George I on 18 May 1725. The name derives from the elaborate mediæval ceremony for creating a knight, which involved bathing as one of its elements. The knights so created were known as Knights of the Bath...
2006-2010 - Sir Nigel Crisp KCBOrder of the BathThe Most Honourable Order of the Bath is a British order of chivalry founded by George I on 18 May 1725. The name derives from the elaborate mediæval ceremony for creating a knight, which involved bathing as one of its elements. The knights so created were known as Knights of the Bath...
2000-2006 - Sir Christopher KellyChristopher KellySir Christopher William Kelly, KCB is a former senior British Civil Servant who is currently the Chairman of the Committee on Standards in Public Life and Chairman of the NSPCC.-Early life:...
KCBOrder of the BathThe Most Honourable Order of the Bath is a British order of chivalry founded by George I on 18 May 1725. The name derives from the elaborate mediæval ceremony for creating a knight, which involved bathing as one of its elements. The knights so created were known as Knights of the Bath...
1997-2000 - Sir Graham HartGraham HartGraham Lloyd Hart was an Australian politician. He was the Liberal member for Mount Gravatt in the Queensland Legislative Assembly from 1957 to 1963....
KCBOrder of the BathThe Most Honourable Order of the Bath is a British order of chivalry founded by George I on 18 May 1725. The name derives from the elaborate mediæval ceremony for creating a knight, which involved bathing as one of its elements. The knights so created were known as Knights of the Bath...
1992-? - Sir Christopher France, (DHSS including social security: 1987-1988, DH: 1987-1992)
- Sir Kenneth StoweKenneth StoweSir Kenneth Stowe GCB CVO is a senior British civil servant. He was Principal Private Secretary to the Prime Minister 1975 to 1979, and the Permanent Under-Secretary of State of the Northern Ireland Office 1979 to 1981. From 1981 to 1987 he was Permanent Secretary of the Department of Health and...
GCBOrder of the BathThe Most Honourable Order of the Bath is a British order of chivalry founded by George I on 18 May 1725. The name derives from the elaborate mediæval ceremony for creating a knight, which involved bathing as one of its elements. The knights so created were known as Knights of the Bath...
CVORoyal Victorian OrderThe Royal Victorian Order is a dynastic order of knighthood and a house order of chivalry recognising distinguished personal service to the order's Sovereign, the reigning monarch of the Commonwealth realms, any members of her family, or any of her viceroys...
1981-1987 (DHSS)
Chief professional officers
The department has six chief professional officers who provide it with expert knowledge and also advise the Ministers, other government departments and the Prime MinisterPrime Minister of the United Kingdom
The Prime Minister of the United Kingdom of Great Britain and Northern Ireland is the Head of Her Majesty's Government in the United Kingdom. The Prime Minister and Cabinet are collectively accountable for their policies and actions to the Sovereign, to Parliament, to their political party and...
. The Chief Medical Officer and Chief Nursing Officer are also directors of the department's board.
- Chief Medical Officer for England (CMO) — Professor Dame Sally Davies, appointed in 2011.
- Chief Nursing OfficerNursing managementNursing management is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling...
(CNO) — Christine Beasley CBE, appointed in 2004. - Chief Scientific Officer (CSO) — Professor Sue Hill OBE, appointed in 2002.
- Chief Dental Officer for England (CDO) — Barry Cockcroft, appointed in 2006.
- Chief Health Professions Officer (CHPO) — Karen Middleton, appointed in 2007.
- Chief Pharmaceutical Officer — Dr Keith William Ridge, appointed in 2006.
Criticism
Introduction of user charges for NHS services
The publication of Professor Lord Darzi's review of the NHS prompted criticism of the government and the department of health for paving the way for user charging, and so contradicting the NHS Plan 2000 which stated that "user charges are unfair and inequitable in they increase the proportion of funding from the unhealthy, old and poor compared with the healthy, young and wealthy". The report also introduces the concept of 'personal budgets'.Fragmentation of NHS services
Darzi's report splits previously integrated services into 'core', 'additional' and 'enhanced' services, which critics say will lead to abandoning the open-ended duty of care on which the NHS was founded."Superbugs" and PFI
Fatal outbreaks of antibiotic-resistantAntibiotic resistance
Antibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a...
bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
("superbugs"), such as Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus is a bacterium responsible for several difficult-to-treat infections in humans. It is also called multidrug-resistant Staphylococcus aureus and oxacillin-resistant Staphylococcus aureus...
(MRSA) and Clostridium difficile
Clostridium difficile
Clostridium difficile , also known as "CDF/cdf", or "C...
, in NHS hospitals has led to criticism of the DH's decision to outsource cleaning via private finance initiative
Private Finance Initiative
The private finance initiative is a way of creating "public–private partnerships" by funding public infrastructure projects with private capital...
contracts as "cutting corners on cleaning".
A "Deep Clean" initiative announced by the Department of Health was criticised by infection control experts and by the Lancet as a gimmick which failed to address the causes of in-hospital infections, by the firms doing the work as an attempt to avoid paying for regular better cleaning, and by NHS managers as ineffective.
It also attracted criticism because only a quarter of the £60m funding for the scheme actually went to hospitals, and because a number of hospitals missed the completion target, and as of June 2008 one in four NHS trusts was not meeting the government's standards on hygiene.
Prescribing
Its advice to primary care on prescribing drugs such as proton pump inhibitors has been criticised as wasteful.Medical Training
The DH has attracted criticism for its disastrous handling of the outcome of Modernising Medical CareersModernising Medical Careers
Modernising Medical Careers is a programme for postgraduate medical training introduced in the UK from 2005 onwards. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of...
, in particular in the changes it made to the specialist training of doctors and the Medical Training Application Service
Medical Training Application Service
The Medical Training Application Service was an on-line application system set up under the auspices of Modernising Medical Careers in 2007 and used for the selection of Foundation House Officers and Specialty Registrars, and allocating them to jobs in the UK...
(MTAS). These changes left "29,193 junior doctors from the UK and overseas... chasing 15,600 posts..." and resulted in accusations that the DH had broken the law by refusing to reveal scores to candidates. Ultimately there was a judicial review
Judicial review
Judicial review is the doctrine under which legislative and executive actions are subject to review by the judiciary. Specific courts with judicial review power must annul the acts of the state when it finds them incompatible with a higher authority...
and a boycott of the system by senior doctors across the country. MTAS was eventually scrapped and Patricia Hewitt
Patricia Hewitt
Patricia Hope Hewitt is an Australian-born British Labour Party politician, who was the Member of Parliament for Leicester West from 1997 until 2010. She served in the Cabinet until 2007, most recently as Health Secretary....
, the then Secretary of State for Health, resigned following accusations that she had lied to the House of Commons over the system. Even after the abolition of MTAS, anger among the medical profession continued, with the British Medical Association
British Medical Association
The British Medical Association is the professional association and registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association’s headquarters are located in BMA House,...
commenting of the DH response that "Not only is this response too late, it does not go far enough".
The official government inquiry into MMC
John Tooke
Professor Sir John Edward Tooke FRCP FMedSci is the Inaugural Dean of the Peninsula College of Medicine and Dentistry, and of the Peninsula Medical School which was its first constituent...
recommended that the responsibility for medical training be removed from the DH.
Recurrent NHS Reorganisation
Successive DH ministerial teams have been criticised for repeated reorganisations of the NHS in England, where primary care commissioning responsibility in particular has been allocated to four different sets of organisations in the last ten years: PCGs, small area PCTs (e.g. covering a rural local authority district or part of a city), larger-area PCTs (e.g. covering a whole County), PCT clusters (e.g. quarter of London or South of Tyne and Wear) and the currently unspecified Clinical Commissioning Groups. The tendency to introduce each reorganisation before its predecessor has had time to settle down and generate improved performance has attracted censure amongst healthcare professions in the UK and beyond, including reference to the ironic concept of 'redisorganization'. Andrew Lansley's promise before the 2010 general election not to impose top-down reorganisation, followed by the instigation from ministerial level of one of the most fundamental NHS reorganisations yet envisaged, has generated especially widespread opprobrium, although some commentators have also suggested that this is to some extenet completing the job started under the Blair administration.Information technology
In recent years the Department of Health and the NHS have come under considerable scrutiny for its use of IT. Since being elected to power in 1997 the Labour government has sought to modernise the NHS through the introduction of IT. Although the policy is correct in aim, many claim its execution is lacking.In September 2008 a new leadership team was established, CIO for Health, Christine Connelly, and director of programme and system delivery Martin Bellamy. Previous CIO Richard Granger was believed to have been the most highly paid civil servant in the UK and was a controversial figure. Connelly left the DoH for a position in the Cabinet Office in June 2009 and was replaced by Tim Donohoe and Carol Clarke.
Connelly's role is to "deliver the Department's overall information strategy and integrating leadership across the NHS", according to the DoH's website. That strategy, known as the National Programme for IT, is intended to do nothing less than revolutionise NHS information workflow and is costed at about £12.7bn. The success or otherwise of Connelly's reign will be based on her promise to end delays of electronic medical records. She has said that if there is not clear progress by November 2009, a new plan could be hatched.
On the eve of the departure of Fujitsu as an outsourcing partner, Connelly said in April 2009 that she would open up sourcing to competition at "acute" sights in the south of England and offer toolkits by March 2010 to allow more local configuration of systems.
In January 2009, MPs criticised DH for its confidentiality agreement with key supplier CSC and in March the Department was admonished by the Information Commissioner for its records management. In May 2011, Prime Minister David Cameron announced that he was considering scrapping the project.
2010-11 Staffing cuts
In response to Government spending reduction targets following the 2008-9 international financial crisis and subsequent recession, DH in common with several other Government Departments resorted to large-scale staffing reductions. In order to minimise redundancy costs, the predominant impact was upon DH staff not employed through a traditional civil service 'headcount' contract, with a resultantly emphasised effect upon more recent or innovative work-streams dependent upon seconded or externally hosted staff. This has attracted criticism from several of the professional and patient communities of interest concerned, for instance as regards the impact upon Improving Access to Psychological TherapiesImproving Access to Psychological Therapies
Improving Access to Psychological Therapies is a United Kingdom initiative to improve access to psychological therapies. It was a result of the economic evaluationsby Professor Lord Richard Layard and Labour Party policy....
(IAPT) and the withdrawal of the practical assistance available to the NHS and local authorities via the National Support Teams
National Support Teams
The public health National Support Teams or NSTs constituted a consultancy-style organisational development and change management service provided by the UK Government Department of Health.-History and role:...
.
Devolution
Most health policy in Scotland, Wales and Northern Ireland is devolved to the department's counterparts:- the Scottish Government Health and Wellbeing DirectorateHealth and Wellbeing DirectorateScottish Government Health and Social Care Directorates are a set of directorates of the Scottish Government. They are responsible for NHS Scotland, as well as policies on the development and implementation of health and community care....
- the Welsh Assembly GovernmentWelsh Assembly GovernmentThe Welsh Government is the devolved government of Wales. It is accountable to the National Assembly for Wales, the legislature which represents the interests of the people of Wales and makes laws for Wales...
- the Department of Health, Social Services and Public SafetyDepartment of Health, Social Services and Public SafetyThe Department of Health, Social Services and Public Safety is a devolved Northern Ireland government department in the Northern Ireland Executive...
, Northern Ireland ExecutiveNorthern Ireland ExecutiveThe Northern Ireland Executive is the executive arm of the Northern Ireland Assembly, the devolved legislature for Northern Ireland. It is answerable to the Assembly and was established according to the terms of the Northern Ireland Act 1998, which followed the Good Friday Agreement...
A number of health issues are, however, wholly or partly reserved to Westminster:
Scotland
- regulation of the health professionHealth professionThe health care industry, or medical industry, is the sector of the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care...
s - abortionAbortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
- xenotransplantationXenotransplantationXenotransplantation , is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenografts or xenotransplants...
- embryologyEmbryologyEmbryology is a science which is about the development of an embryo from the fertilization of the ovum to the fetus stage...
, surrogacySurrogacySurrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...
and human geneticsHuman geneticsHuman genetics describes the study of inheritance as it occurs in human beings. Human genetics encompasses a variety of overlapping fields including: classical genetics, cytogenetics, molecular genetics, biochemical genetics, genomics, population genetics, developmental genetics, clinical genetics,... - medicines, medical supplies and poisons
Northern Ireland
- xenotransplantationXenotransplantationXenotransplantation , is the transplantation of living cells, tissues or organs from one species to another. Such cells, tissues or organs are called xenografts or xenotransplants...
- surrogacySurrogacySurrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...
- human fertilisationFertilisationFertilisation is the fusion of gametes to produce a new organism. In animals, the process involves the fusion of an ovum with a sperm, which eventually leads to the development of an embryo...
and embryologyEmbryologyEmbryology is a science which is about the development of an embryo from the fertilization of the ovum to the fetus stage... - human geneticsGeneticsGenetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
In Northern Ireland, abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
law is a criminal justice matter and is devolved.
Wales
Under the Welsh devolution settlement, specific policy areas are transferred to the National Assembly for Wales
National Assembly for Wales
The National Assembly for Wales is a devolved assembly with power to make legislation in Wales. The Assembly comprises 60 members, who are known as Assembly Members, or AMs...
rather than reserved to Westminster. As the distinction between Government and actual health services is seen as less pronounced than in England, the main source of information about current developments is NHS Wales.
See also
- Government of EnglandGovernment of EnglandThere has not been a government of England since 1707 when the Kingdom of England ceased to exist as a sovereign state, as it merged with the Kingdom of Scotland to form the Kingdom of Great Britain...
- United Kingdom budgetUnited Kingdom budgetThe United Kingdom budget deals with HM Treasury budgeting the revenues gathered by Her Majesty's Revenue and Customs and expenditures of public sector departments, in compliance with government policy.Adjustment is achieved with the GDP deflator....
- Healthcare in the United Kingdom