Mr Griffiths, former deputy chief executive of the NHS Executive, called for a full debate on purchasers and providers in the public sector. He suggested that hospital trusts should form independent non-profit-making bodies outside the service. In the absence of a considered debate, the NHS could only develop in 'a piecemeal way without any context, subject to the worst effects of short-termism'.
He was speaking after suggesting on BBC radio that the logical next step was a system in which the state continued to buy services for patients but painted a picture of an NHS that was more of a concept than an institution.
He called on the Conservatives and Labour to work out a future, together: 'When we look at the institutions providing the services we have to ask how they will devolve in five or 10 years. We have to find a way of providing the service that does not have attached to it the grubby label of commercialisation,' he said.
Mr Griffiths, 49, is also the former chief executive of the Guy's and Lewisham Trust, the 'flagship trust' of the NHS, who took a tough line faced with budget problems and proposed 600 redundancies. He is now deputy director of the influential, independent health policy organisation, the King's Fund.
His ideas stop short of privatisation but look to an entirely new form of public service provider, which could be drawn from experiences with charities, the voluntary sector or non-profit-making organisations. 'But the new model must retain the ethics and the ethos of the public sector. In my view the public would not accept privatisation,' he said.
His views sparked an argument between Virginia Bottomley, Secretary of State for Health, and David Blunkett, Labour's health spokesman. Mrs Bottomley distanced herself from the idea of non-profit-making independent hospitals. 'That is certainly not on my agenda,' she said. 'The trusts have been set up, accountable to the Secretary of State. That is the agenda for the future.' But she allowed that co-operation with the private sector would continue.
Mr Blunkett, in a letter, challenged her to make an unequivocal statement on her future intentions. He said that her junior colleagues 'appeared to relish the increasing privatisation'.
About one-fifth of jobs in the blood donor service are threatened by a shake-up which will reduce the number of centres in England from 15 to 10, writes Liz Hunt.
Sir Colin Walker, chairman of the National Blood Service, denied yesterday that the reorganisation was a preliminary to privatisation. 'There is no hidden agenda to privatise the service and we believe in the voluntary system of blood donation,' he told a press conference in London to announce the changes which are designed to cut about pounds 10m out of the annual budget of pounds 130m.
Sir Colin confirmed that closure of one-third of the centres would mean some staff reductions over three years, but that the NBS hoped to achieve this through natural wastage. The unions, however, immediately condemned the plans and said that public safety may be put at risk by the changes.
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