Last update 15th. May 2004


Top down practice

Dear Alex

Thanks for your email. Obviously, what follows is simply my interpretation.

A top down practice is one that believes the essential truths are concentrated at the centre or in the Commission's case at national level, particularly Central Government level. It means that the Commission defines itself far more by how it is serving some aspect of Government policy than by listening to the Forums, acting on the messages they give and arguing the case the Forums present with Central Government.

One example was the emphasis put by the CPPIH Chief Executive on the Government targets she had to meet and by implication our role as forums in enabling her to do this. A top down practice looks at Forums to be controlled rather than nurtured in the statutory independence they have.

Of course, the Commission should seek a good relation with Government of whatever colour and meet targets but it should be a critical friend to Government just as Forums should be critical friends to the respective NHS bodies they are working with.

My view is that the Commission hasn't got the balance right at the present time.

Happy to discuss further.

Hilary Barnard

Camden PCT Forum