Think tank suggests scrapping NHS England with £100bn of funding given to 38 ‘super councils’

Spending and control of more than £100bn of key public services – including the NHS – should be devolved to 38 “super councils”, according to radical new research released today.

A report from think tank Reform has suggested that NHS England be scrapped completely, with control of its services distributed to 38 new authorities covering the entire country.

Devolution of 95% of the NHS England budget would make the organisation redundant, and the report proposes that it be disbanded and all other powers be commissioned directly within the Department of Health.

Researchers said the current centralised commissioning process, which sees government spend 75% of the £335bn annual budget for public services, has failed to deliver outcomes “that matter” and provide value for money for taxpayers.

The new “super councils” would be led by a single leader who is locally elected and accountable for all decisions.

Funding would be provided to these authorities in block grants after they meet high-level targets agreed centrally with the government to cover five-year periods.

The report concludes: “Government must be brave to drive the legislative and cultural change necessary to make this work.

“But it would be working with the grain: recent governments have set the devolution ball in motion, and the governance structures necessary already exist.

“This provides an important platform from which government, at all levels, can provide a vision; a vision for more effective public services that work for all.”

The report also suggested the government alter the role of the Cities and Local Growth Unit to include oversight of the devolution of public services. The new ‘Devolution Unit’ would have members from all the departments which powers are devolved from.

These proposals are supposed to aid in creating a more efficient and targeted system in the UK. Based on the principal that local leadership would be better able to deal with people’s needs than central government.

Reform, which produced the research, is a right-wing think tank specifically aimed at improving the balance between economic prosperity and public service funding.

Top image: Design Council and Andy Smith 

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