Consultation response
11 Oct 2010
Project:
The NHS White Paper and Health and Social Care Bill
Area of work:
NHS & social care reform

Previous attempts to make the NHS more accountable to local residents and patients have had limited success. The 2010 NHS White Paper: Equity and excellence: Liberating the NHS outlined Government plans to make the NHS more responsive by increasing consumer power, and giving local government more influence over how health services are shaped. In this paper we analyse the latter set of proposals, as outlined in ‘Increasing democratic legitimacy in health’.

Summary

The Nuffield Trust believes in the importance of both accountability and legitimacy within a publicly funded health care system. Our analysis reveals pressing contradictions between the stated goal of more local influence, and the strong lines of accountability upwards from GP consortia to the central NHS commissioning board.

Among the suggestions we make for resolving this deficit are a clearer role for the local public and patients within the governance structures of GP consortia, and adequate resources so that Health and Wellbeing Boards can monitor the configuration and quality of local services

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