Who runs the NHS?
Getting the right balance between central and local control
The NHS is a £120 billion business, with life and death decisions made on a minute by minute basis. It continues to be one of the British institutions that the public cares most deeply about, often coming ahead of the royal family. And when it came to increasing public spending last year after a decade of austerity, the NHS was first in line for a major budget boost.
Following a series of reforms dating back to the creation of the internal market in the early 1990s, the issue of who is accountable in the NHS has been a regular feature. Since the early 1990s, politicians have sought to hand responsibility down to a more regional and local level and the 2012 Health and Social Care Act took this further by handing the NHS more operational autonomy on a day-to-day basis through the creation of the NHS Commissioning Board (what has now become NHS England/Improvement).
The NHS Long Term Plan signalled an intention to devolve more power and autonomy to the regional level through the creation of Integrated Care Systems, which will cover every part of the country by April 20201. This approach has been welcomed by many front-line NHS leaders who want to see less central control.
With a number of different arms-length bodies and regional and local organisations now in place – some with formal legal status, others without – have we got the right balance between central control and local accountability? Where should the balance be struck to ensure we empower local leaders to deliver the ambitions of the Long Term Plan, while ensuring leaders and services are held to account?
Ultimately, where should accountability lie for an organisation with 1.4 million staff and which now takes up 17 per cent of total public spending in the UK?
This annual debate from the NHS Confederation will aim to provide some answers to these questions. Join our panel of front-line leaders, politicians and commentators, chaired by NHS Confederation chief executive Niall Dickson.
2.00pm Annual General Meeting (Open to all, but voting will only be open to members)
2.10pm Panel discussion
3.40pm Closing remarks
3.50pm Networking and drinks reception
The General Meeting
This event will include the NHS Confederation’s general meeting, the proceedings of which will take no longer than ten minutes. Guests are invited to join us for the entire event, but the Chair will politely request that only members participate in the vote to pass a special resolution.
Formal notice of the 2019 AGM including an electronic/ postal proxy form will be sent to members.
Members may send one or more representatives to the AGM who between them have one vote (on behalf of that member) per motion.
Members who are unable to attend but would still like to vote in the AGM are entitled to appoint a proxy by completing a Proxy Form. An electronic/ postal Proxy Form will be sent with the notice next week.
If you wish to receive a hard copy Proxy Form by post, please contact the Charity on 020 7799 8696 or email: firstname.lastname@example.org