Review

Things done in our name

ADVANCE OF THE QUANGO STATE
Chris Skelcher, Stuart Weir and Lynne Wilson
Local Government Information Unit, 2000, £15.00

At a time when the latest ‘re-disorganisation’ of the NHS is in full swing, and bureaucracy is being ‘cut’ by creating up to 500 new local health care commissioning groups, it is good to return to one’s political ‘first principles’ and think about the need for democracy.

Democracy in the health service has been a matter of debate for very many years. Yet, as the authors of this admirably clear and well-argued report show, the tide has been flowing very strongly in the opposite direction.

Increasingly, public administration is being farmed out to an enormous number of quangos, with often limited requirements for openness or transparency in their activities and decision-making processes. In some cases – and one might reasonably point to Primary Care Groups and Trusts – there are also clear conflicts of interest between the public and private roles of quango members. It’s time for a democratic renewal, as they say.