These initiatives – and in particular the devo-health ‘experiment’ in Greater Manchester – throw up a range of questions for policy makers and the public. How much power should be passed down to the local level within health and care? Who should they be passed down to? What should local leaders do with these new freedoms? Will this process lead to the democratisation of health and care decisions and speed up reform? Or, will it hinder the ability to deliver an efficient and effective health and care system?
Over the last year or so, IPPR has been looking to answer these questions from a contemporary perspective. However, we also recognise that historians of the British health system will likely feel a sense of déjà vu as they look at these developments. For questions of how to reconcile the goals of a national service (fairness, efficient use of resources) with the benefits of devolved powers (democratic control, community integration) are not new. Indeed, they go right back to the creation of NHS in 1948.
It is our hope that this set of essays, authored by leading historians of both the health and care system and the decentralisation of public services, will help shed light on some of the debates, feeding into the ongoing discussions at national and local level about the role of localism and centralisation within health and care. We hope you find them both interesting and informative.
State of the North 2024: Charting the course for a decade of renewalThe North’s communities are ambitious for a better future, but face systemic and pronounced inequalities. Gaps in power, wealth, opportunity, and health result in shorter, sicker, less fulfilling lives.
No home left behind: Funding a just transition to clean heat in ScotlandHow can we ensure that investment in clean heating in Scottish homes drives a just transition, sharing costs and benefits fairly?
The asylum backlog: Job done?This blog post sets out how the department must now grapple with a new set of backlog challenges.