Governing the commissioning organisations
In recent years, the role of commissioning in the NHS (in the most basic terms, the buying of health services) has undergone a transformation. From a position where it was only undertaken at the whole system level – and then only in a very limited way and in a manner better described as planning – it became a totemic function of the English NHS. If health services could be provided by any number of private sector and independent providers then arguably what helped retain the ‘public’ nature of the idea of the NHS was its command of the allocation of resources. The loud and effective championing of the idea of ‘World Class Commissioning’ (with its strap line ‘Adding Life to Years and Years to Life’) hoisted this erstwhile relatively peripheral function centre stage. Attempts were made to shift the entire raison d’etre of the PCTs so that they become solely and purely commissioning bodies. Whilst WCC and PCTs have been eclipsed in favour of the GP consortia, the concept of commissioning, in England at least, remains crucial.