Congratulations on you superb and balanced debate on politics in healthcare! It was clear from your panel that strategic direction and accountability must lie with politicians when public money is being spent - a very welcome stance, it is just a shame that it does not happen now.

Congratulations on you superb and balanced debate on politics in healthcare! It was clear from your panel that strategic direction and accountability must lie with politicians when public money is being spent - a very welcome stance, it is just a shame that it does not happen now.

Recent ministerial protests against reconfigurations demonstrate that lines of accountability simply do not exist at present. How can it be that ministers can complain about strategic direction set by the government that they are a part of? How can local MPs represent their constituents on health care when they have no influence on strategy, are not accountable and are not able to hold ministers to account?

The only way that politicians can have accountability for strategic direction and decisions is for them to have the responsibility for these decisions as well. This entails the NHS being taken out of the hands of central government and placed with local government and it also requires a change in the system of representation to one of proportional representation to ensure true accountability back to tax payers.

We are half way there in Scotland and Wales, let us hope that England can start down this road soon.

Stuart Jeffery, Health spokesperson, Green Party of England and Wales