An NHS Constitution

Doubtless establishing David Cameron’s proposed NHS Board, first suggested by Gordon Brown, and later taken up by the BMA.

But the NHS, through the Secretary of State for Health, is currently accountable to the House of Commons. It is also consistently the electorate’s number one concern.

Already, thanks to Brown and cheered on by Cameron, the electorate, as such, actually cannot even care about interest rates, even though the public certainly does. And Brown and Cameron both now seem determined to do the same thing to health policy, once again reversing one of Labour greatest democratising achievements.

With no say over either monetary policy or health policy, what will politicians be for? There will still be education, and transport, and policing, and social security, and foreign policy, and defence, and a host of other matters. But for how much longer? The precedent will be well and truly set. Parliament will go the way of local councils, except voluntarily.

We should insist on a directly elected NHS Board, if we must have one at all. In Scotland, Wales, Northern Ireland and each of the nine English regions, we would each vote for one candidate. The top three would be elected to serve a four-year term. There would also be a Chairman, appointed by the Secretary of State with the approval of the House of Commons. The Board would meet in public under any circumstance when a council would do so. And the candidates would be sufficiently independent to qualify in principle for the Remuneration Panels of their local authorities.

This pattern would also be applied to the BBC Governors (in which case the voters and candidates would be licence-payers), to Ofcom, to the Press Complaints Commission, and to the Human Fertilisation and Embryology Authority, just for a start.

Not the necessary restoration and extension of the powers both of Parliament and of local government. But a few steps in the right direction.