Department of Health (United Kingdom)
From Wikipedia, the free encyclopedia
The Department of Health (DoH) is a department of the United Kingdom government but with responsibility for government policy for England alone on health, social care and the National Health Service (NHS). It is led by the Secretary of State for Health with two Ministers of State and three Parliamentary Under-Secretary of States.
The DoH carries out some of its work through "arm's length bodies", including executive agencies such as the NHS Purchasing and Supply Agency (NHS PASA) and the Medicines and Healthcare products Regulatory Agency (MHRA).
In the rest of the United Kingdom, responsibility for health and the management of the NHS falls under the jurisdiction of the devolved governments of the other three constituent countries, namely:
- the Department of Health, Social Services and Public Safety of the Northern Ireland Executive
- the Scottish Government Health Department
- the Welsh Assembly Government
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[edit] 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.[1]
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 National Health Service 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.
Information obtained by Conservative shadow health spokesman Stephen O'Brien shows that between 22 August 2005 and 3 August 2007, there have been close to 1,500 occasions when the department's IP address (the code that identifies which computers are being used on the internet) has been associated with the creation or amendment of entries on the encyclopaedia website Wikipedia[2]. Exactly what the Department of Health has been amending is yet to be revealed.
[edit] Location
The official headquarters and Ministerial offices are in Richmond House, Whitehall, London. Many staff are in Skipton House, Elephant and Castle, London and were formerly in Alexander Fleming House and Hannibal House there. There are also many staff based in Quarry House in Leeds, in Wellington House near Waterloo station in London and in New King's Beam House near Blackfriars Bridge.
[edit] Ministerial team
The current ministers at the DH are:.[3]
- Secretary of State for Health — The Rt Hon. Alan Johnson, MP
- Minister of State for Public Health - The Rt Hon. Dawn Primarolo, MP
- Minister of State for Health Services and Minister for the South West — Ben Bradshaw, MP
- Parliamentary Under Secretary of State for Care Services — Ivan Lewis, MP
- Parliamentary Under Secretary of State for Health Services - Ann Keen, MP
- Parliamentary Under Secretary of State - The Rt Hon. The Lord Darzi of Denham
[edit] Permanent Secretary
The Permanent Secretary at the Department of Health was Sir Nigel Crisp from 2000 to 31 March 2006. Unlike his predecessors as permanent secretary, Sir Nigel Crisp was also Chief Executive of the NHS. Following his early resignation in March 2006, it was announced that the posts will be split. David Nicholson was appointed as Chief Executive of the NHS in September 2006. Hugh Taylor was appointed as the Permanent Secretary in December 2006 after serving as Acting Permanent Secretary following Sir Nigel Crisp's decision to retire.
Previous permanent secretaries:
- Sir Kenneth Stowe GCB CVO 1981-1987 (DHSS)
- Sir Christopher France, (DHSS including social security: 1987-1988, DoH: 1987-1992)
- Sir Graham Hart KCB 1992-1997
- Sir Christopher Kelly KCB 1997-2000
- Sir Nigel Crisp KCB 2000-2006
[edit] 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 Minister. The Chief Medical Officer and Chief Nursing Officer are also directors of the department's board.
- Chief Medical Officer for England (CMO) — Professor Sir Liam Donaldson, appointed in 1998.
- Chief Nursing Officer (CNO) — Christine Beasley CBE, appointed in 2004.
- 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.
- Chief Scientific Officer — Professor Sue Hill, appointed in 2002.
[edit] Criticism
[edit] "Superbugs" and PFI
Fatal outbreaks of antibiotic-resistant bacteria ("superbugs"), such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, in NHS hospitals[4] has led to criticism of the DoH's decision to outsource cleaning via Private Finance Initiative contracts as "cutting corners on cleaning"[5].
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[6], by the firms doing the work as an attempt to avoid paying for regular better cleaning[7], and by NHS managers as ineffective[7].
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[8].
[edit] Prescribing
Its advice to primary care on prescribing drugs such as proton pump inhibitors has been criticised as wasteful[9].
[edit] Medical Training
The DoH has attracted criticism for its disastrous handling of the outcome of Modernising Medical Careers, in particular in the changes it made to the specialist training of doctors and MTAS. These left between 8,000 and 12,000 junior doctors without careers, resulted in accusations that the DoH had broken the law by refusing to reveal scores to candidates[10], and ultimately prompted a judicial review, a boycott of the system by senior doctors across the country[11], and ultimately the scrapping of the system they put in place[12] and the resignation of the then Secretary of State for Health Patricia Hewitt following accusations that she had lied to the House of Commons over the system[13]. Even after the abolition of MTAS, anger among the medical profession was widespread, with the British Medical Association commenting of the DoH response that "Not only is this response too late, it does not go far enough"[11].
The official government inquiry into MMC recommended that the responsibility for medical training be removed from the DoH[14].
[edit] Waste
Spending on surveys of patient views has been attacked as inefficient and poorly thought out, with one Healthcare for London Review[15] led by Ara Darzi and intended to reveal what London residents wanted to see improve in the NHS seeing just 1,500 responses despite an initial budget of £1m. Rather than deciding to scrap the project, the DoH instead decided to spend another £14m on it, a decision described as "scandalous" in the national press and heavily criticised by patient groups[16].
[edit] See also
[edit] References
- ^ Health Departments. www.ndad.nationalarchives.gov.uk. The National Archives. Retrieved on 2006-11-07.
- ^ Oliver Marre (2008-02-24). The NHS tries another form of doctoring. The Observer.
- ^ Department of Health Ministers
- ^ Labour hails fall in MRSA cases. BBC news (2005-03-07). Retrieved on 2008-02-28.
- ^ NHS trust warned over hygiene breaches. The Telegraph (2008-02-07). Retrieved on 2008-03-30.
- ^ Thelancet, (2007). "The traditional white coat: goodbye, or au revoir?". Lancet 370 (9593): 1102. doi:. PMID 17905145.
- ^ a b Hospital deep cleaning under fire. BBC News (2008-01-14). Retrieved on 2008-03-30.
- ^ Hospital deep clean target missed. BBC News (2008-03-29). Retrieved on 2008-03-30.
- ^ Andrew Moore (2000-10-06). Waste in the NHS: the problem, its size, and how we can tackle it. Balliol College, Oxford. Retrieved on 2008-03-26.
- ^ Health Department ‘broke law over doctors’ job test scores’. Times Online (2007-05-22). Retrieved on 2008-03-26.
- ^ a b Review into doctor recruitment. BBC news (2007-03-07). Retrieved on 2008-03-26.
- ^ John Carvel. Hewitt backs down in junior doctor row. The Guardian. Retrieved on 2008-03-26.
- ^ Hewitt 'misled Commons' over MTAS. Channel 4 (2007-05-19). Retrieved on 2008-03-26.
- ^ Nigel Hawkes, Health Editor (2008-01-08). Department of Health ‘must be stripped of doctors’ training role’. The Times. Retrieved on 2008-03-26.
- ^ Healthcare for London - Ideas River. Retrieved on 2008-05-10.
- ^ Department of Health blows £15million on NHS survey - Sunday Mirror (2008-02-24). Retrieved on 2008-05-10.
