Health Protection Agency to be abolished as Lansley axes quangos

Bureaucracy will be cut and the functions of several organisations will be streamlined, following a review of arm’s length bodies (ALBs), Health Secretary Andrew Lansley announced today.

The changes outlined in today’s report will reduce the number of health ALBs from 18 to between eight and 10 and are expected to deliver savings of more than £180 million by 2014/15.

In line with the wider reforms set out in the White Paper, Equity and Excellence: Liberating the NHS, the Department of Health’s ALB sector will be transformed to cut cost and remove duplication and burdens on the NHS.

The review has assessed whether the work of each of the Department of Health’s 18 Arm’s Length Bodies’ remains essential nationally. It also looked at whether work is being duplicated or could be better carried out by a different body.

Subject to Parliamentary approval, organisations which are no longer needed will be removed from the sector, with essential work moved to other bodies. The Government believes this process will increase the ability of the organisations to do their important work in the most efficient way.

It is also part of the cross-Government strategy to increase accountability and transparency, and to reduce the number and cost of quangos.

Health Secretary Andrew Lansley said: "In order to secure every possible means to promote greater value for money and efficiency, we have acted decisively to ensure that our ALB sector remains fit for purpose and affordable.

"Over the years the sector has grown to the point where overlap between organisations and duplication of effort have produced a needless bureaucratic web. By making sure that the right functions are being carried out at the appropriate level, we will free up significant savings to support front-line NHS services.

"I know that the uncertainty created by this review has been difficult for staff. The constructive support of the Chairs and Chief Executives of all the organisations has been invaluable throughout this process. We will be supporting them to carry on their essential work during and beyond the period of transition."

In line with the efficiency savings being made across the health sector, remaining ALBs will be required to deliver their functions effectively and efficiently, taking full advantage of commercial opportunities.

The Department will work with each organisation affected by the changes over the next few months to help them through the transition process.  The form of this work will vary according to the nature and scale of the change for each organisation.

The conclusions of today’s review and outcomes for each organisation are set out below.

Arm’s Length Body: Alcohol Education and Research Council
ALB Type: Executive Non Departmental Public Body (ENDPB) and registered charity
Role: Administers the Alcohol Education and Research Fund
Proposal: Abolish as an ALB and remove from the sector, while seeking to maximise the opportunities for effective cross-government policy to reduce the harm from alcohol misuse.

Arm’s Length Body: Appointments Commission
ALB Type: ENDPB
Role: Makes public appointments
Proposal: Abolish as an ALB during 2012 in view of the very substantial reduction in the number of appointments required. Move remaining appointments to the Department of Health.

Arm’s Length Body: Care Quality Commission
ALB Type: ENDPB
Role: Regulates health and adult social care provision
Proposal: Retain as quality inspectorate across health and social care, operating a joint licensing regime with Monitor. Host organisation for Healthwatch England. Current responsibility of assessing NHS commissioning moves to the NHS Commissioning Board. May gain functions from other organisations, e.g. HTA and HFEA.

Arm’s Length Body: Council for Healthcare Regulatory Excellence
ALB Type: ENDPB
Role: Oversees professional regulators
Proposal: Remove from the sector. Make a self-funding body by charging a levy on regulators. Extend role to set standards for and quality assure voluntary registers.

Arm’s Length Body: General Social Care Council
ALB Type: ENDPB
Role: Regulates social workers
Proposal: Transfer the regulation of social workers to the Health Professions Council, which will be renamed to reflect its new remit.

Arm’s Length Body: Health and Social Care Information Centre
ALB Type: Special Health Authority (SpHA)
Role: Collects and provides health and social care information
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. National repository for data collection across health care, public health and adult social care. Clearer focus on data collection, with a close working relationship with the NHS Commissioning Board.

Arm’s Length Body: Health Protection Agency
ALB Type: ENDPB
Role: Protects the health and wellbeing of the population
Proposal: Abolish as a statutory organisation and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: Human Fertilisation and Embryology Authority 
ALB Type: ENDPB
Role: Regulates human embryo storage, research and assisted reproduction treatment
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HFEA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre.

Arm’s Length Body: Human Tissue Authority
ALB Type: ENDPB
Role: Regulates the removal, storage and use of human tissue and organs
Proposal: Retain as a separate ALB for the time being, with the aim of transferring its functions by the end of the current Parliament. In the meantime, we will examine the practicalities (and legal implications) of how to divide the HTA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre.

Arm’s Length Body: Medicines and Healthcare products Regulatory Agency
ALB Type: Executive agency
Role: Regulates medical devices and medicines
Proposal: Retain, but with the expectation that it will undertake its regulatory duties in the most cost effective way.

Arm’s Length Body: Monitor
ALB Type: ENDPB
Role: Assesses, licences and monitors NHS Foundation Trusts
Proposal: Retain and make an economic regulator, operating a joint licensing regime with CQC.

Arm’s Length Body: National Institute for Health and Clinical Excellence
ALB Type: SpHA
Role: Provides national guidance on the promotion of good health and the prevention and treatment of ill-health
Proposal: Retain, and put on a firmer statutory footing by establishing it in primary legislation. Expand scope to include social care standards.

Arm’s Length Body: National Patient Safety Agency
ALB Type: SpHA
Role: Promotes patient safety and manages the National Clinical Assessment Service, the National Research Ethics Service and confidential enquiries.
Proposal: Abolish as an ALB. Safety functions retained and transferred to the National Commissioning Board. Explore transfer of National Research and Ethics Service functions to single research regulator. National Clinical Assessment Service to become self-funding over the next two to three years.

Arm’s Length Body: National Treatment Agency for Substance Misuse
ALB Type: SpHA
Role: Works to increase the availability, capacity and effectiveness of drug treatment in England 
Proposal: Abolish as an ALB, and transfer functions to the Secretary of State as part of the new Public Health Service.

Arm’s Length Body: NHS Blood and Transplant
ALB Type: SpHA
Role: Provides blood, organs and associated services to the NHS
Proposal: Retain, and commission an in-depth review of opportunities to make more commercially effective. Transfer Bio-Products Laboratory out of NHSBT into a Department of Health owned company.

Arm’s Length Body: NHS Business Services Authority 
ALB Type: SpHA
Role: Provides central services to the NHS
Proposal: Retain in short term, and commission commercial review to identify potential for increased commercial opportunities, including potential to remove functions from the ALB sector.

Arm’s Length Body: NHS Institute for Innovation and Improvement
ALB Type: SpHA
Role: Supports the NHS by spreading new ways of working, new technology and leadership
Proposal: Remove from ALB sector. Move functions which will support the NHS Commissioning Board in leading for quality improvement to the Board. Review the potential for its remaining functions to be delivered through alternative commercial delivery models.

Arm’s Length Body: NHS Litigation Authority
ALB Type: SpHA
Role: Handles negligence claims and works to improve risk management practices in the NHS 
Proposal: Retain, and commission an industry review to identify potential opportunities for greater commercial involvement.

Martin Barnes, chief executive of DrugScope, said the progress of the National Treatment Agency "needs to be preserved".

He added: "The announcement that the NTA's functions will be transferred to the new public health agency and not abolished is encouraging - it is vital that drug treatment continues to be championed.

"The transfer is likely to mean a greater and welcome focus on tackling alcohol-related harms and on drugs as a public health issue.

"But recovery from addiction requires the support and engagement of a range of local agencies, including providers of housing, training and employment, and it is crucial that this partnership approach is reflected across departments within Government."

Peter Walsh, chief executive of the charity Action against Medical Accidents, said: "There is no denying that there is scope for bringing some of the quangos together; however, we must avoid the danger that work on patient safety could be watered down in the new arrangements.

"We will want to be assured that the new arrangements will include safeguards to ensure that patient safety really does get the priority it needs and that the skills, knowledge and passion of those who currently champion patient safety are transferred to the new body.

"It would be a mistake not to build on the start that has been made on patient safety, which would inevitably lead to many more avoidable tragedies."

Dr Peter Carter, chief executive of the Royal College of Nursing, said: "Many of the organisations facing significant change have been instrumental in protecting and promoting good health - it is vital that their many benefits do not fall through the gaps in a re-organised service.

"Today's announcement will raise many questions for nurses, particularly for those currently working for the organisations affected.

"It would be a devastating waste of talent for the knowledge and expertise of this highly skilled workforce to be lost as services are reviewed."

Vivienne Nathanson, head of science and ethics at the British Medical Association (BMA), said: "The proposals to downscale or close a number of organisations have far-reaching implications and the BMA will need to study the consultation in detail before commenting fully.

"While we agree that it may be possible for some functions, for example IT, finance and human resources, to be shared, the BMA will need to be assured that the essential work currently undertaken by these bodies is not damaged.

"In terms of public health, the Health Protection Agency (HPA) has been a very effective body in helping England to respond effectively to public health threats, including Sars, pandemic flu and polonium poisoning.

"The fact that the HPA has been a standalone body has always been seen as beneficial - public health messages are often more effective coming from this agency than the Government."