MPs Criticise Health Bill's Removal of Council Health Board Seats

Legislation currently progressing through the House of Commons proposes significant changes to how NHS Integrated Care Boards (ICBs) are composed in London. Under the Health Bill, seats currently held by members nominated by local authorities would instead be filled by individuals put forward by the Mayor of London. This shift has drawn criticism from London MPs who believe it will negatively impact healthcare planning across the capital.

Concerns Over Local Representation

ICBs are responsible for managing local NHS budgets, planning health services, and commissioning care for their populations. London currently has five such boards. The proposed reforms would remove the requirement for at least one member to be jointly nominated by the local authorities within an ICB's area. Instead, a nominee of the Mayor of London would be required. MPs on the House of Commons health and social care committee have urged ministers to reconsider, noting that unlike other mayoral authorities, the Greater London Authority does not have devolved health or social care powers.

Labour MP Ben Coleman, representing Chelsea and Fulham, told the Local Democracy Reporting Service that a uniform approach to ICBs would not work across the country. He stated, "We need proper, democratic representation. We have that at the moment with the local authority model." Coleman highlighted the importance of social care, which councils provide, for preventing hospital admissions and ensuring timely discharges. He added that the Mayor of London does not hold responsibility for health or social care, making the proposed change illogical. "It makes no sense to get rid of all the local authority places in the London ICBs," he said, as reported by the Barnet Post.

Danny Beales, another Labour MP on the committee, described the move as "a step backwards" that "waters down" collaboration. He argued that removing local authorities from decision-making tables is short-sighted, particularly in the context of shifting towards preventative healthcare. Beales suggested that while such measures might suit areas with integrated health models within mayoral authorities, like Manchester, they are not suitable for all regions. The Barnet Post reported his view that local authorities would not be "round the table with decision-makers".

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Potential for Flexibility

There are indications that the application of new guidance for London might offer some flexibility. Former health secretary James Murray acknowledged the distinct position of the Greater London Authority compared to other mayoral combined authorities. He stated that while a mayoral representative will be required, there is flexibility in what individual ICBs can do. "We are aware of London’s unique position. We have committed to putting out further guidance about how we will approach different parts of the country. This includes London," Murray told the committee, as reported by the Barnet Post. He added that the issue is specific to London and requires tailored guidance.

A spokesperson for the Mayor of London, Sadiq Khan, did not take a definitive stance on the proposed changes. The spokesperson stated that the proposed reforms offer a chance for city-wide leadership to reduce health inequalities. They also affirmed that local councils are critical partners in improving health and that commitment to joint leadership and partnership working remains. NHS England and the Department for Health and Social Care did not respond to requests for comment, according to the Barnet Post.

The Health Bill continues its passage through the House of Commons, with MPs seeking greater certainty that local councils will retain a role in London's ICBs.