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Think-tank calls for NHS democracy

Commissioning authorities in the NHS must investigate alternative - and more effective - techniques for involving the public in strategic decisions, according to a new repor from the Institute for Public Policy Research. Such techniques might include citizen’s juries or even some form of ‘electronic democracy’.

The IPPR also calls for a move towards more open governance in the NHS, and proposes that the idea of local authority control of health commissioning be piloted in a few places, and extended if successful.

The report, Voices off: tackling the democratic deficit in health, argues that the NHS reforms have made rationing decisions explicit, but have not provided any way for public views to influence such decisions directly. It says that HAs should be required to consult their local populations systematically, and publish their findings openly.

In 1992 the government launched the Local voices intiative, designed to encourage HAs to involve local people in commissioning activities. Yet the IPPR found that activities in different districts vary widely, with the direct costs of the exercise ranging from £900 in one district to £100,000 over 2 years in another.

The report also calls for a ‘radical overhaul’ for community health councils, giving them new powers and establishing them independently of the NHS.

Institute for Public Policy Research, 30-32 Southampton Street, London WC2E 7RA.