Devolve NHS England's £168bn budget to local government, says report

By Dan Peters | 02 April 2024

NHS England’s £168bn budget should be handed to local government in a radical restructure, the Reform think-tank has suggested in a report today.

The report proposed ‘all but a few specialist NHS services’ be devolved to local government, which would offer core hospital services and be able to spend the money as it wished provided it met minimum standards of care agreed by the Department of Health and Social Care (DHSC).

It argued this would end the current system of fragmented funding streams between hospitals, community care, GPs and social care, and allow more joined-up care, incentivising prevention.

The report admitted a new localised health system would require a huge increase in the size of local government.

Last month’s The MJ Future Forum heard the relationship between local government leaders and the NHS was ‘immature at best and dysfunctional at worst’.

Senior well-placed sources have privately warned ‘something was starting to go wrong’ in Integrated Care Systems as planned cuts to Integrated Care Board (ICB) staffing levels threaten to land councils with an increased burden.

The Local Government Association is understood to have reported a host of issues being raised about ICBs amid fears DHSC and NHS England will pull back up to the centre.

Head of health at Reform, Rosie Beacon, said: ‘New locally-tailored approaches to health are needed which are rooted in specific community need; that’s impossible if NHS activity is dictated by a remote national body.’

Speaking at the Future Forum session in Hertfordshire, chief strategy officer at NHS England, Chris Hopson, underlined his support for the current structure of ICB and Integrated Care Partnerships.

Hopson added: ‘I genuinely believe we have the right statutory structure to make these relationships work.’

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Health Whitehall Local Government Association Devolution NHS Transformation