The proposed abolition by the Government of health watchdogs such as the Health Protection Agency (HPA) and the National Patient Safety Association (NPSA) has met with concern from health experts.
Health Secretary Andrew Lansley has announced a review of the UK's health arm's length bodies (ALBs) that will reduce their number from 18 to between 8 and 10, delivering savings of over £180m by 2015.
The review calls on arm's length bodies "to exploit commercial opportunities and maximise commercial discipline," reflecting a growing role for the private sector in delivering NHS functions.
The decision to abolish the NPSA has led to concerns over patient safety, while the transfer of the HPA's role to the DH has been criticised as reducing its independence. The abolition of the NHS Institute for Innovation and Improvement (NIII), responsible for improving the uptake of new technologies, may raise issues for the medtech industry.
Health Secretary Andrew Lansley said: "In order to secure every possible means to promote greater value for money and efficiency, we have acted decisively to ensure that our ALB sector remains fit for purpose and affordable.
"In line with the efficiency savings being made across the health sector, remaining ALBs will be required to deliver their functions effectively and efficiently, taking full advantage of commercial opportunities."
NICE will be placed on a stronger statutory footing, with its remit expanded to include social care. Monitor will be retained and will become an economic regulator. MHRA will be retained, but is expected to operate more cost-effectively.
The functions of the HPA, which has handled public health hazards (such as swine flu) since 2003, will be transferred to the Health Secretary as part of the new Public Health Service. The safety functions of the NPSA will be transferred to the National Commissioning Board. The functions of the NIII will be divided between the NCB and private sector organisations.
Fertility watchdog the Human Fertilisation and Embryology Authority (HFEA) will be abolished by 2015, with its main functions transferred to the new Care Quality Commission. The HFEA has been criticised by Lord Winston and others for excessive regulation of fertility treatments.
The proposed ALB cull is widely recognised as promising to reduce bureaucratic red tape and unnecessary expense. However, some concerns have been raised. Peter Walsh, Chief Executive of the charity Action against Medical Accidents, said: "There is no denying that there is scope for bringing some of the quangos together, however we must avoid the danger that work on patient safety could be watered down in the new arrangements."
Hugh Pennington, Emeritus Professor of Bacteriology at Aberdeen University, criticised the transfer of the HPA's functions: "The HPA is an absolutely essential national resource," he said. "It's quasi-independent and a degree of separation between it and the rest of government gives it more scientific freedom and independence."