Andy Burnham's flagship promise to devolve power to the local level will not apply to the NHS if the current health bill passes into law in its present form, according to Daughne Taylor, chair of the National Lead Governors Association. In a letter responding to Burnham's 10-year devolution proposal, Taylor argues that the bill removes the statutory requirement for NHS foundation trusts to have an independent council of governors.
Current safeguards under threat
Currently, NHS foundation trusts are legally required to have a council of governors composed of unpaid volunteers democratically elected from the public and staff. These councils operate independently of NHS management, represent local views, and hold the vital power to appoint the chair of the trust. However, the health bill in its current form would eliminate this requirement, effectively allowing local trusts to "mark their own homework" while trust chairs would be appointed centrally from Whitehall.
Taylor emphasizes that this centralization is the "absolute antithesis" of Burnham's devolution proposals. Instead, she advocates for all trusts to have a statutory council of governors, which should remain independent of NHS management, represent the public and staff, be responsible for appointing trust chairs, and hold a statutory right to speak "truth to power" at board meetings. She argues that implementing such legislation is not just about democracy but is a safety measure to help prevent local NHS disasters before they escalate.
Call for federal UK
John Marriott of North Hykeham, Lincolnshire, also responds to Burnham's devolution plan, cautioning against devolving power and money to individuals rather than democratically accountable organizations. He warns that if Burnham is considering creating more elected mayors, he must ensure these individuals are up to the task. Marriott points out that current local mayors operate with budgets of around £25 million each, limiting their potential for damage, but if real money and power are at stake, a more radical approach is needed.
Marriott advocates for nothing short of a federal United Kingdom, modeled on Germany. He argues that the overwhelming economic power of England over Northern Ireland, Wales, and Scotland needs to be diluted by creating six or seven directly elected regional assemblies in England. This would leave the federal parliament in London responsible for a narrow portfolio including foreign affairs, defence, and economic development, with a senate drawing its members from the regions and nations of the UK to scrutinize legislation.
