The HDA is among 18 health bodies axed. What's going on at the DOH?

As part of its contribution to the government's much-trumpeted public sector savings, the number of so-called arms-length health bodies will be nearly halved at the cost of 11,000 jobs. One body for the chop is the Health Development Agency. But what are arm's length bodies anyway and how will health care be affected? To answer that question, you'll want to read the MHF's guide to the ALBs.

Streamlining not nice for the Health Development Agency

The Health Development Agency is to be abolished in a streamlining of the number of NHS bodies that work at 'arm's length' from the Department of Health. Health Secretary John Reid believes £500 million can be saved in this way and channelled into patient care.

He told the House of Commons in a written statement that 'reducing the cost of arm's length bodies will generate resources that are the equivalent of four new hospitals or 20,000 more nurses by 2008. The arm's length body sector has done a lot of good work, but it has grown over several decades and no longer meets current health and social care needs or those of future generations.

'Arm's length bodies need to be streamlined in number and functions. They must adopt a different approach so that their functions are delivered effectively and the time spent by frontline staff responding to central needs is minimised.'

What are arm's length bodies?

ALBs are stand-alone national organisations sponsored by and accountable to the Department of Health. Legally, there are three main types of ALB:

• Executive Agencies of the Department of Health
• Executive Non-Departmental Public Bodies (set up in primary statute with their own powers)
• Special Health Authorities (set up in secondary legislation to perform functions delegated to them by the Secretary of State)

Confusingly, the Health Development Agency is actually a special health authority so just becuase you're called an agency doesn't mean you are an agency. The first ALB was the Dental Practice Board established in 1948. In 2003/4, there were 38 ALBs.

• More on this from the Cabinet Office

Who will be affected?

Since May 1997, the Department has already abolished more than 15 bodies. The new shake-up will see the number of Department of Health arm's length bodies reduced by almost half from 38 to 20 and see a 25 per cent reduction in the 22,000 staff working in the sector by 2008.

The TUPE (Transfer of Undertaking, Protection of Employment) Regulations which act to preserve employee terms and conditions where work is transferred to other organisations do not apply to transfer of administrative functions within the public sector but the Cabinet Office

says it has a statement of practice to ensure that staff are treated no less favourably than had TUPE applied.

The government says: 'All employers have a duty to try to avoid redundancies and this key principle will underpin the processes that are developed to manage the change. There are a number of ways of

ensuring this happens and we will expect organisations to work together to ensure that redeployment processes are in place to match displaced people to available posts wherever possible. Where redundancies do take place staff will be entitled to the packages and notice periods that

pertain to their contracts of employment.'

What are the specific changes?

The changes include:

• the Health Development Agency (HDA) will be abolished with the National Institute for Clinical Excellence (NICE) taking on the work to link standards on the prevention and treatment of ill health.
• the Mental Health Act Commission will be abolished with the Healthcare Commission taking on its responsibilities under mental health legislation.
• a new Regulatory Authority for Fertility and Tissue will be created to encompass the work of the Human Fertilisation and Embryology Authority (HFEA) and the proposed Human Tissue Authority.
• the Commission for Patient and Public Involvement in Health (CPPIH) will be abolished and stronger, more efficient arrangements will be put in place to provide administrative support and advice to Patients' Forums.
• the National Patient Safety Agency (NPSA) will support independent ethical reviews of all research that could affect patients and take the lead on hospital food, cleanliness and safe hospital design. It will also become responsible for national confidential enquiries from the National Institute for Clinical Excellence (NICE). 
• NHS Estates will be abolished.
• the Health Protection Agency will assume functions from the Public Health Laboratory Service (PHLS) and the role of the National Radiological Protection Board (NRPB), which will both be abolished
• a new Blood and Transplant Authority will be created to encompass the services provided by the National Blood Authority and UK Transplant, which will be abolished.
• the NHS Litigation Authority (NHSLA) will be reconstituted to oversee the proposed NHS redress scheme and manage financial compensation nationally. It will also take on the functions of the Family Health Services Appeal Authority, which will be abolished.
• a new Health and Social Care Information Centre will be created to reduce burdens on the frontline by co-ordinating information requirements across a wide range of bodies. The new Centre will retain some of the information-related functions of the current NHS Information Authority, (NHSIA) which will be abolished, and take on the statistics and information management functions of the Department.
• the National Programme for Information Technology will become an executive agency for three to five years, incorporating the IT functions of the NHSIA.
• a new NHS Business Services Authority will be created to replace the NHS Pensions Agency, the Dental Practice Board, the Prescriptions Pricing Authority and the NHS Counter Fraud and Security Management Authority, which will all be abolished.

The chief executives of both NICE and the HDA have welcomed their particular merger. Andrew Dillon, chief executive of NICE said: 'Bringing NICE and the HDA programmes together offers the chance to make more than just the sum of parts. We will work closely with our colleagues in public health to ensure that this is the case.

Paul Streets, chief executive of the HDA said: 'We welcome this announcement as it brings to an end speculation about the future of the work we have been doing. It is gratifying to know that our work will continue and we look forward to working with NICE to create what will be one of the most influential health and health care guidance organisations in the world.'

How will it be done?

Over the summer, the government will be looking at how the changes will be implemented and over what timescales. The Department plans to develop a  memorandum of understanding on human resources processes with those organisations affected by the review. This will be developed in partnership with the relevant arms length bodies.

• Click here for full details from the DOH