Dr. Sara Burke:

I think it has the authority but there are fundamental problems with it in that it is responsible also for the day-to-day delivery of the health system, which is consistently under pressure. Therefore, it is difficult for that board to have the time or headspace to deliver on reform. Moreover, delivering on reform requires doing very differently what is being done every day, hence the original recommendation that there be an engine to drive the reform. I still think we need to have an engine to drive the reform but also to do the sort of boring tasks such as producing progress reports, action plans and key indicators of success such that the likes of this committee and those of us on the outside can monitor the programme’s success. We need that engine room but I do not see it.