What future for the Department of Health?

Almost from its birth the NHS has been haunted by a vision. In it, the service emerges from the tutelage of central government as an independent corporation emancipated from control by civil servants and no longer vulnerable to sudden ministerial whims or political pressures. It is an idea that has surfaced from time to time, as in the report of the 1979 Royal Commission'; it has also been considered in private ministerial ruminations about the future of the NHS. In the past it has usually been dismissed as tempting but politically naive and constitutionally irregular. Now, however, its time may have come. In 1992 the NHS Management Executive is to move to new headquarters in Leeds. The move will give even more visibility to its increasingly independent role and force into the open a debate that has already begun within the Department ofHealth: a debate about the respective roles of the executive and the department. If the management executive is the body responsible for running the NHS-a sort of protocorporation, albeit at present still embedded in central government -what is the department's future?