Devolution bill poses a serious threat to the NHS

Devolution bill poses a serious threat to the NHS The little discussed and barely comprehended bill has reached committee stage in the Commons, and has significant implications for the health service.

The penny is beginning to drop within the NHS world at last. The seemingly marginal cities and local government devolution bill, now in its Commons committee stage, has major implications for the NHS that have been little discussed and barely comprehended. It all began with Greater Manchester combined authority securing control of its £6bn NHS budget earlier this year, and now several other devolution bids to the Treasury are seeking some NHS remit.

The problem here is not so much that the idea is necessarily wrong in principle, but rather that it hasn’t been thought through. Regions seeking such powers need to meet the Treasury’s requirement of securing “a financially sustainable health and social care system” by 2020. Typically they will claim to be able to do so by developing community-based models of care that focus on preventing expensive hospital treatment. In reality there is little evidence to suggest this model will work.

... ones which achieve or exceed their initial goals in such a way that they become embedded; able to survive a change of government; represent a starting point for subsequent policy development or remove the issue from the immediate policy agenda. Continue reading... The Guardian