• IPPR report accuses ministers of “preventing devolution” in the NHS
  • Sadiq Khan reiterates his call for devolved health powers for London
  • Welfare and justice should also be devolved so areas can address social determinants of health, report says

Ministers have been accused of “preventing devolution of healthcare budgets and powers” in a new report.

The Institute For Public Policy Research report, shared with HSJ and due to be published later on Wednesday, calls on the government to show more commitment to devolution of NHS responsibilities.

Sadiq Khan

Sadiq Khan

Sadiq Khan said ‘real power needs to be devolved from central government’ to cities

The think tank said ministers’ approach to NHS devolution to date had been “more delegation than devolution” and “could fail to deliver on its potential unless Westminster relinquishes some control”.

Mayor of London Sadiq Khan, commenting on the report ahead of its publication, reiterated his call for devolution of NHS responsibilities in London.

He said: “In order to ensure that Londoners have access to the best NHS services real power needs to be devolved from central government to London and other cities.

“This IPPR report makes it clear that people in the capital will benefit from a system which is more flexible and better able to meet the demands and manage the health of their communities.”

The report points out that in Greater Manchester – the only area which has been given substantial powers over health and care as part of a devolution deal – “the health secretary rather than the newly elected mayor will remain ultimately accountable”.

It says: “Going forward, this may need to change, with local mayors given clearly defined roles in the NHS and the centre stepping away from its responsibilities, in order to give local leaders ‘skin in the game’ and enable local communities to hold them to account.”

The report is backed by former Labour health secretary Alan Milburn, who is chair of the think tank’s health advisory panel.

IPPR researcher in health and wellbeing Harry Quilter-Pinner said: “Health devolution must be more than a half-way house if we are serious about it working. Locally elected mayors need the powers to make changes to the way health services are run in their areas to better serve the people that live there.”

The report says devolution arrangements should cover criminal justice and welfare as well as the NHS and care, so they can address non-healthcare determinants of health.

It says NHS devolution it not right for all areas but “should be considered as one option in looking to drive reform going forward”. NHS England chief executive Simon Stevens has cast doubt on similar arrangements being put in place elsewhere in the near future.

A Department of Health spokesman told HSJ: “We are committed to the devolution of healthcare [responsibilities] where that improves patient outcomes.

“Clearly Greater Manchester and other areas have well defined plans, and we are excited to see the results.”

Read the report

Ministers accused of 'preventing real NHS devolution'