Codes of conduct and accountability for NHS boards

Corporate governance has had a high profile for several years. In the private sector the corporate governance debates and controversies resulted in the setting up of the Committee on the Financial Aspects of Corporate Governance (the Cadbury Committee). This committee published the Cadbury Report and the Cadbury Code of Best Practice in December 1992. Once the Cadbury Report had articulated a best practice for the private sector (albeit one applicable mainly to large companies), other types of organisations seeking to emulate the private sector began to investigate the possibility of producing their own codes. The National Health Service set up a Corporate Governance Task Force which produced a report (Public Enterprise Governance in the NHS ) which contained draft codes of conduct and accountability for NHS Boards and was released to NHS chief executives on January 27, 1994. The Secretary of State invited comments to be made on the codes by February 18, 1994. The final versions of the codes were issued by the Secretary of State on April 28, 1994 and were accompanied by an Executive Letter from the NHS Executive containing guidance on their implementation. This paper examines the contents, status and method of operation of the codes of conduct and accountability for NHS Boards. It is argued that, despite their appearance as the NHS version of Cadbury, these codes differ from their private sector counterpart both in the purposes they serve and in their methods of operation. The analysis of the codes provides an interesting case study of the transfer of private sector concepts to the public sector. It illustrates how these concepts can be distorted so that private sector rhetoric ceases to have its private sector meaning and instead acquires a different, public sector, meaning during the transfer process.