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Introduction of user charges for NHS services The publication of
Professor Lord Darzi's review of the NHS prompted criticism of the government and the Department of Health, claiming that it paved the way for user charging, and so contradicting the
NHS Plan 2000 which stated that "user charges are unfair and inequitable in they increase the proportion of funding from the unhealthy, old and poor compared with the healthy, young and wealthy". The report also introduces the concept of
personal budgets.
Fragmentation of NHS services Darzi's report has led to criticism in 2008 of the department's decision to outsource cleaning via
private finance initiative contracts as "cutting corners on cleaning". A "Deep Clean" initiative announced by the Department of Health was criticised by infection control experts and by the Lancet as a gimmick which failed to address the causes of in-hospital infections, by the firms doing the work as an attempt to avoid paying for regular better cleaning, and by NHS managers as ineffective. and as of June 2008 one in four NHS trusts was not meeting the government's standards on hygiene.
Prescribing Its advice to primary care on prescribing drugs such as
proton pump inhibitors has been criticised as wasteful.
Medical training The DH has attracted criticism for its handling of the outcome of
Modernising Medical Careers, in particular in the changes it made to the specialist training of doctors and the
Medical Training Application Service (MTAS). These changes left "29,193 junior doctors from the UK and overseas... chasing 15,600 posts..." and resulted in accusations that the DH had broken the law by refusing to reveal scores to candidates. Ultimately there was a
judicial review and a boycott of the system by senior doctors across the country. MTAS was eventually scrapped and
Patricia Hewitt, the then Secretary of State for Health, resigned following accusations that she had lied to the
House of Commons over the system. Even after the abolition of MTAS, anger among the medical profession continued, with the
British Medical Association commenting of the DH response that "Not only is this response too late, it does not go far enough".
Recurrent NHS reorganisation Successive DH ministerial teams have been criticised for repeated reorganisations of the NHS in England, where primary care commissioning responsibility, in particular, has been allocated to four different sets of organisations in the last ten years: PCGs, small area
primary care trusts (PCTs) (e.g. covering a rural local authority district or part of a city), larger-area PCTs (e.g. covering a whole county), PCT clusters (e.g. quarter of London or South of Tyne and Wear) and the currently unspecified Clinical Commissioning Groups. The tendency to introduce each reorganisation before its predecessor has had time to settle down and generate improved performance has attracted censure amongst healthcare professions in the UK and beyond, including reference to the ironic concept of 'redisorganisation'.
Andrew Lansley's promise before the 2010 general election not to impose top-down reorganisation, followed by the instigation from ministerial level of one of the
most fundamental NHS reorganisations yet envisaged, has generated especially widespread opprobrium, although some commentators have also suggested that this is to some extent completing the job started under the Blair administration. The NHS as of 1 April 2013 is no longer situated within the DH, as NHS England also went 'live' at the same time. Therefore, the DH has a further scrutiny role of NHS services and commissioning. ==Information technology==