Ministers should be removed from making decisions about hospital closures and mergers, and the powers transferred to local authorities, says a report from influential think-tank the IPPR. The report this week says that because the decisions are currently taken by national politicians, residents automatically assume they are politically-driven or to do with budget cuts, even though they may agree that change is necessary. It adds: ‘Local people cannot turn to the PCT boards, as they are unelected, nor to councillors, as they have limited influence. The vacuum is currently filled by MPs, who can lobby at Westminster. This is counter-productive.' Instead, it says the powers of the Independent Reconfiguration Panel, set up in 2003, should be enhanced withLGA-nominated members on its reviews. The panel, which currently can only be called in by ministers to advise on local hospital restructuring, should in future be called in only by council scrutiny committees. It adds: ‘Local authorities scrutinising hospital changes which affect a wider area would delegate their referral powers to a joint scrutiny committee pooled with representatives of other areas.' However, it says councils should not ‘have the final say' and the NHS ultimately must decide on clinical grounds. ‘Our proposals would make the local NHS more accountable through stronger local scrutiny,' it adds. The IPPR report comes during a major row about whether smaller district hospitals should be closed in favour of larger, specialist units. There is speculation Gordon Brown wants to make a bold initiative with the NHS, putting it more at arm's length and reducing it as a political liability. The future hospital: The politics of change. Joe Farrington-Douglas with Richard Brooks. IPPR. May 2007.
