Quango cull of health bodies is coalition's third assault on NHS

The latest batch of health bodies being abolished or "reconstituted" is the coalition's third assault on what the health secretary, Andrew Lansley, calls "a needless bureaucratic web". His radical white paper on NHS reform in July announced the abolition of England's 10 strategic health authorities and 152 primary care trusts, involving the loss of thousands of jobs. Soon after he said his department's 18 arm's-length bodies (ALBs) would be reduced to eight, nine or 10 to "cut cost and remove duplication and burdens on the NHS". They included bodies which play key, and independent, roles such as the Human Fertilisation and Embryology Authority (HFEA), the regulator of the mainly private fertility treatment sector; the Health Protection Agency (HPA), which monitors and controls infections; the National Patient Safety Agency (NPSA), which tries to reduce clinical errors and the National Treatment Agency for Substance Misuse, which aims to wean drug addicts off their habit. The HFEA's abolition has drawn criticism from the patient charity Infertility Network, the British Fertility Society, which represents fertility specialists and the British Medical Association. Voicing "very serious concerns" about the loss of the HFEA and Human Tissue Authority, the BMA said they had "well-served" the UK "and both have been used as models for other jurisdictions". Lansley says he is enhancing transparency, but there has been no public consultation on his plans. Like his NHS reforms, usual rules of policy-making have been set aside. He accepts that most of the functions of most of these bodies will still need to be done, and thus they are being transferred to, for example, the Department of Health or the planned new Public Health Service. So existing influential government advisory bodies such as the Joint Committee on Vaccination and Immunisations Scientific Advisory Committee on Nutrition will be reborn as expert committees. This is greater centralisation of advice and decision-making from a minister pledged to decentralisation.