NHS England accused of ‘top-down power grab’ by council leader and campaigners

Islington’s council leader has called for greater democratic accountability within the NHS, amidst warnings that its reforms could make the system less transparent.

Speaking at a meeting organised by campaign group Keep Our NHS Public (KONP), leader of the council Cllr Richard Watts (Lab, Tollington) called for service users to have more control over the NHS.

The borough’s top councillor warned of a “power grab” by NHS England through structural changes planned over the next decade – a view echoed by Dr John Lister, KONP co-chair and founder member.

Cllr Watts said: “There are some really worrying changes going on in our health service, quite a lot of which is a power grab by the NHS nationally, at the expense of locally democratically accountable structures, like local authority involvement in the NHS which I personally support.

“If you have an issue with social care, you can come to me as your democratically elected council leader, and you can hold me to account for that. I don’t shirk those responsibilities at all.

“You can’t say that anywhere else within the health and care system, and I think there is a role for proper democratic accountability for how we shape those services.”

Coming in for stern criticism from KONP were proposals for integrated care systems (ICS), which will see a change in the way the NHS partners with other organisations, such as councils, to deliver health services.

KONP argues the new system, which will initially be rolled out in 14 areas across the country, including Suffolk, Bedfordshire and South Yorkshire, will lead to less accountability.

NHS England claims otherwise, describing the changes on its website as “a new form of even closer collaboration between the NHS and councils”.

Its aim is to have every part of England covered by an ICS by 2021.

The roll-out is being developed in 14 areas across the country, including Suffolk, Bedfordshire and South Yorkshire.

There are no plans as yet for an ICS in Islington.

The borough’s health services are currently governed by clinical commissioning groups (CCG) within North Central London Sustainability and Transformation Partnership (STP), which also includes Barnet, Camden, Haringey and Enfield CCGs.

Dr Lister said: “We’re being told that each of the STP areas is going to be an Integrated Care System.

“Is it going to be integrated? Probably not. Does it care? Not very much. There is going to be one clinical commissioning group (CCG) per ICS. North Central London on that basis for example would have one merged CCG covering the whole area.

“This runs into questions of local accountability. You take half a dozen CCGs down to one in these areas, who are they accountable to? You live in one part of the area, how do you get your voice heard?

“ICSs are not going to be public bodies. They won’t hold public meetings, publish papers, and they won’t have any power to take any decisions.

“They will be there to rubber stamp proposals which emerge in the background, are implemented without discussion, and carried through without responsibility to local people.”

Dr Lister went on to characterise the introduction of ICS as a centralising “top-down power grab” by NHS England, which could deprive people seeking to shape policy of a place to raise their views.

Cllr Tricia Clarke (Lab, St George’s) said: “The 10-year plan separating itself from scrutiny committees and not be accountable is a very worrying part of the plan.

“We get a chance to get the top people in the NHS and hospital trusts and we get to question them.

“I’m not saying we can actually change what they’re doing, but we get to question them and hold them to account.”

NHS England were approached for comment, but had not responded by time of going to press.