| Local NHS Democracy |
| Wednesday, 28 October 2009 | |
 "The local NHS is a huge taxpayer-funded service, affects everyone, is important to everyone, but is sadly totally remote from democratic decision making." These formed part of my opening remarks when I introduced the The Local Health Services and Democratic Involvement Bill to Parliament last week under the ten-minute rule . Please take a minute to offer your support.
The Bill seeks to require, among other things, Primary Care Trusts to obtain prior approval for their spending plans, involving relevant locally elected authorities. Currently, decisions are made by enlightened, but unelected, quangos or trusts, and they are usually a combination of medical experts and appointees who may or may not bring relevant expertise with them. They decide what drugs are available, which hospitals or hospital departments stay open, where services are, how GPs and dentists shape up, and what after-hours care exists. All those issues mean a lot to some people part of the time, and much to all people most of the time. We just need to remind ourslves about Children's A&E to appreciate that point. I propose that primary care trusts, as currently constituted, lay before the health scrutiny committees of existing councils, as currently constituted, their annual plans and their big decisions - not for scrutiny or consultation, but for approval, agreement and amendment. I propose a kind of democratic lock on the local NHS: a move beyond mere consultation. I propose a genuine redistribution of power from one existing institution to another existing, established institution. This is such a good idea that I believe that the model has already been embraced voluntarily in some areas. |