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Local control of NHS and police services financed with supplementary local taxes

“Local NHS PCTs and police services should be run by the people they serve, with each able to raise additional funds through local taxation.”

2. How does it fit with Compass’ core beliefs of equality, solidarity, democracy, freedom, sustainability and well being?

Local services should be locally accountable rather than being run be appointees or opaque committees. We should increase local democracy by electing local people directly to bodies with real power to deliver their services. We should have separate direct elections for PCTs and Police Authorities. Each should then set its own budget and decide on manning levels based on the electoral mandate. Any excess should be paid by a levy on local council tax payers. The American clergyman Jonathon Mayhew (1720-1766) demanded “no taxation without representation.” I say “no representation without taxation.”

3. How does it build the institutions of social democracy, like social groups and collective and cooperative forms of ownership and control?

This would allow local people to decide on local health and policing priorities. Central Government should set minimum levels of care and service and provide funds accordingly, but local PCTs and Police Authorities could enhance their service provision if they could persuade the local community to fund it. Services would then be responsive to local needs rather than being imposed on communities from Whitehall.

4. How much will it cost or raise and where will any cost come from?

A possible small rise in council tax.

5. Which groups in the electorate are likely to support or oppose this measure? Is there any polling evidence you have on this?

It would run counter to the centralising tendency of most Westminster politicians and civil servants, but voters may embrace it.

6. Is there a place or country where it’s worked? Please provide some information.

Most communities in the USA have local control of law enforcement. Pay and staffing levels are decided locally.

7. What are the three main arguments in favour/against it?

For
(i) It would increase local involvement and ownership of services.
(ii) Local services would run more efficiently if they were subject to local management oversight.
(iii) Health and policing would become less of a political football at national level. There would be fewer empty Government promises and initiatives, and consequently less cynicism.

Against
(i) It would lead to post-code lotteries on health provision.

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