New NHS body set to take the reins from government

Alistair Henderson, acting director of the new NHS Employers Organisation, talks to Michael Millar about what this new body will mean for management of the health service, and whether Government will be able to quit interfering with decisions

In October 2004, the NHS Confederation will launch a new employers’ organisation for the NHS in England.

Ownership of and responsibility for the HR agenda will be devolved from central government to employers for the first time in NHS history.

This is a radical step when you consider that NHS founder Nye Bevan famously said: “The sound of a bedpan dropped on the floor of a hospital should reverberate throughout Whitehall.”

The new Employers’ Organisation (EO) will conduct national negotiations over pay, terms and conditions and new contracts. It will represent the views of employers and support them through advice, information and networking, and it will also promote the National Health Service as an employer of choice.

Alistair Henderson, acting director of the Employers’ Organisation, sees this as a major shift in power and responsibility.

“The Department of Health (DoH) was always keen to get the views of NHS employers, but at the end of the day, it did what it wanted because it is the DoH,” he said. “In the past, we had the department to make the decisions, and that was always comfortable because we could always blame them.

“As an employers’ organisation, we can’t do that – we have got to be confident that we are truly representing and doing what NHS employers want.”

To do this, the EO has proposed a two-tier representational process. An EO Assembly, with a membership of 203, will convene once or twice a year to set broad parameters and policy directions for the EO. From that, a policy board will be drawn of about 20 people. It will take day-to-day responsibility for the policy of the organisation, as well as determining strategic direction and appointing negotiating groups.

Henderson believes the key to the EO’s success will lie in making HR a key strategic player, and not just creating an “HR ghetto”.

“We need people from the right kind of roles, and input will come from HR, CEOs and financial directors, as well as medical officers to ensure the strategic objectives are met,” he said.

The DoH said the EO will be run ‘without interference from Whitehall’, but the deal includes approximately 50 civil servants transferring from the DoH to the EO to fulfil functions around pay negotiations and a series of ’employment issues’, including recruitment and retention initiatives, responsibility for health and safety, equality and diversity, and best employment practice.

But does Henderson really believe central government will let go of the proverbial bedpan?

“This is to stop the reverberating bedpan,” he said. “I think the intentions are entirely sincere, but it is also important to be realistic and sensible. This is the public sector, and therefore we will have to operate within the funding limits and the policy framework set by Government.

“That’s not an undue or wicked restriction. It would be absurd to think otherwise. The Government is going to have a huge interest in how large amounts of public expenditure are spent.

“However, I genuinely believe that Government does see that it can’t get involved in those day-to-day decisions, and that it does want to devolve responsibility. What it will want to do is set an overall funding envelope, it will set some policy priorities, and then it will be up to us.”

Henderson is keen to impress upon NHS management the importance of taking hold of their own destiny.

“It is a major change that I’m not sure the NHS has grasped yet about owning [this agenda], being engaged and making decisions, and taking responsibility for this agenda,” he said.

“This has never happened before. This really is a shift in the balance of power.”

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