David Cameron's comments about the National Health Service today have been heartening to say the least.They've served to highlight another issue however. The inequality between the services provided by the NHS in each of the Home Countries. Dr Gill Morgan, who is the chief executive of the NHS Confederation, is reported to have said that devolution has caused even more of a 'post code lottery' in health care.
The Daily Telegraph reports the situation here.
She suggests that there is unlikely to be any 'health migration' within the UK. That comment misses the point to my mind. The fact that there are inequalities in the service provided in each of the home countries is bad enough. What is worse is that the situation remains where MPs from the three nations with devolved powers continue to decide on the health policies of the nation that has no devolved government.
It's time that English MPs voted on English matters. Only then can the health priorities of England be truly, democratically addressed.
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Even better, why don't we let Britain decide Britain's health priorities? It is wrong for the Union to be fragmented - creating an English Parliament would only increase this, not to mention the increases in bureaucracy, cost (both for the institution itself and for the salaries of those attached to it), and inefficiency.
Why don't we abolish devolved "national" assemblies and have a strong, national, British Parliament and local councils with greatly improved powers? Abolish district and county councils and form unitary authorities across the UK; this will boost efficiency, speed up the decision-making process and make councillors more immediately accountable to their public. The cost burden would also be lessened. At the same time, grant local councils the ability to vary tax by a 2% margin in the same way that these devolved national assemblies already do - after all, the cost of living in the north of Scotland is less than the cost of living in the south of England.
When this has been completed, we then bolster the influence of local town and parish councils, to create a truly effective two-tier system of an encompassing unitary authority with strong local voices spread through it in the form of town councils. Do we really need to keep devolved national assemblies and county, borough and district councils in that mixture?
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