Legislation announced in the queen's speech will give local government a wider role in scrutinising the health service. Here, we present the case for and against:
NHS trusts are undemocratic and accountable only upwards. Scrutiny from politicians elected by local people will help bridge the gap between communities and health service boards.
It is true that NHS bodies are accountable ultimately to the (democratically elected) secretary of state. However, many local councillors sit on NHS trust, health authority and primary care group boards, even though they are appointed, rather than directly elected.
Local government scrutiny will help to end spats between councils and the health service over issues such as hospital closures.
Giving local government closer scrutiny powers over the NHS will not end spats over hospital or ward closures - indeed it may generate more and more bitter clashes.
In-depth scrutiny from councillors will help open up the workings of NHS trusts to the general public.
It is true that, historically, the NHS has been fairly secretive about how and why it makes its decisions. However, that is changing. Trusts are required to open board meetings to the public, while the NHS is bound by a code of openess. That said, the NHS has generally been rather blasé and tokenistic about consulting with the public over service changes, and council scrutiny will force trusts and health authorities to properly justify their proposals.
The fact that the council scrutineers are not health professionals improves the chance that they will be able to better inform the public about health policy.
The NHS does have a lot to learn about using plain English rather than institutional jargon, and plain-speaking councillors may have an educative role here. On the other hand, many in the NHS would argue councillors are blithely ignorant of developments in modern healthcare, and are often stubbornly obsessed with retaining potent NHS symbols such as cottage hospitals, regardless of clinical safety issues or cost effectiveness.
Joining up health and other local services is essential to the government's regeneration policies. Giving councils powers of scrutiny can only lead to closer working between the NHS and local government.
Not neccessarily. The two parties might be better informed about what each is doing, but that is unlikely in itself to lead to blissful marriage. Councillors, particularly if they belong to a party in opposition to the governement, may have a vested interest in either wrecking local initiatives, or of pandering to local voter opinion regardless of what is best for the local health economy.
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