Title

HEALTH

Streeting's health experiment

The health deals recently handed to mayors could resolve flaws that have dogged the NHS since its inception, writes Matthew Taylor

© 5mggg / shutterstock

We may be reaching what could come to be seen as an important inflection point for the NHS and general health policy. To understand its significance, it's worth going back to basics.

Eighty years ago, the NHS was born with two design weaknesses. The first is that the service is too centralised nationally, a characteristic captured in Aneurin Bevan's promise that the sound of a bedpan dropping in Tredegar would ‘reverberate in the corridors of the Palace of Westminster'. The second is it is too locally fragmented, mainly because of the deal with GPs allowing them to remain independent businesses, but also because important elements of health and care policy have sat with local government.

Matthew Taylor

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