Editorial Wednesday 19 October 2011: Professor Grant confirmed chair of NHS Commissioning Board in split decision

The Commons health select committee has confirmed the appointment of Professor Malcolm Grant as the first chair of the NHS Commissioning Board.

This is despite his describing the Health And Social Care Bill in his oral evidence session as "unintelligible".

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However, the committee divided along party lines over the decision, with Labour members Grahame Morris, Virendra Sharma and Rosie Cooper opposing the endorsement and Sarah Woolaston and Daniel Poulter of the Conservatives and Lib Dem Andrew George supporting it.

The Labour members tabled the following amendment:

“We acknowledge Professor Grant’s distinguished academic career and that he has been a distinguished Provost of University College London. Nevertheless, we do not endorse  Professor Grant’s candidacy for the post for the following reasons:
1. Professor Grant demonstrated a lack of experience of NHS structures and processes
2. Professor Grant did not demonstrate to the Committee a robust understanding of the issues affecting the NHS
3. Professor Grant acknowledged to the Committee that the Department of Health assisted in the preparation of answers to the written questions posed by the Committee
4. Professor Grant did not demonstrate to the Committee a clear understanding of how the NHS Commissioning Board would intervene in the case of commissioner failure
5. Professor Grant was not robust in terms of the advocacy role of the Chair of the NHS Commissioning Board
6. Professor Grant was unclear about the means by which the NHS Commissioning Board would seek service reconfiguration locally
7. Professor Grant demonstrated an assumption that his appointment was already confirmed
8. Professor Grant made a reference to the Health and Social Care Bill he is required to implement as being unintelligible
9. Professor Grant did not persuade the Committee that he would provide an effective counterbalance to the executive members of the NHS Commissioning Board.”—(Grahame M Morris.).

Labour's amendment was not supported.

The committee then voted on endorsing the candidacy, and split on the same lines. It therefore required the casting vote of committee chair Stephen Dorrell to endorse Professor Grant’s candidacy.

This is an interesting and inauspicious start to Professor Grant’s chairmanship. While in protocol terms the DH-provided support with his answers to the committee's written questions (which appear at the back of the report) is not procedurally amiss, according to a senior Whitehall figure, it looks a little odd. It has also rankled with some of the select committee.

The NHS Commissioning Board is to be held to account by the select committee annually: Professor Grant may find that this leads to ramifications in his next session.