Comments on: A National Health Service - Locally Run

By: RobertHoward

RobertHoward — Thu, 29 Jan 2009 11:15:13 +0000

Until local government re-organisation in 1974, primary health care was managed by a local ‘Medical Officer of Health’, who published an annual report and was answerable to a ‘Health Committee’ of local councillors. Sometimes, other members of the local community served as co-opted members. It was a system which worked well, but the government wanted to unify NHS services and create regional and local NHS bodies to manage all NHS services — which is how and why we lost democratic control. In return for this loss of control, we were given Community Health Councils, which worked well in some cases, but New Labour abolished CHCs ten years ago, since when we have had no real local input into NHS services, which is accountable to local people in any real way. Of course the local control of NHS services will bring local and regional variations in services, but different parts of England have different needs and priorities. Personally, I believe local communities and councillors, as our elected representatives, can be trusted to manage health services once again. As someone who worked in the voluntary health sector for over thirty years, until I retired, I am in no doubt that many ‘professionals’ believe they know best and regard councillors and local communities with patronising disdain. The NHS can, and should, be run by local people and local NHS staff.

By: elro

elro — Fri, 23 Jan 2009 17:39:41 +0000

If real power is devolved to local bodies then differential provision is inevitable, no doubt followed by an outcry over the ‘post code lottery’ in health care.

By: Martin Rathfelder

Martin Rathfelder — Wed, 19 Nov 2008 12:00:14 +0000

The issue is not really the unelected bureaucrats. We will always have them. The real issue is who they are answerable to. In effect the only elected accountable people in the NHS are the ministers in each of the 4 countries. In Wales and Scotland and NI that seems to give a degree of local accountability, though in Scotland there is pressure to elect local health boards. But in England there is an issue about where to introduce democracy. A regional tier would be most logical, but we don’t have the infrastructure to support it. We could elect PCT boards. But maybe what we should be doing is giving the commissioning responsibilities of the PCT to elected local councils.