Radical new devolution offer needed in England, thinktank says

The devolution agenda in England needs to be ‘drastically accelerated’, an independent thinktank has argued.

Reform has released a report, Vive la devolution: devolved public-services commissioning, which argues that commissioners have not worked with providers to tailor service design to outcomes that matter to everyone using public services.

It argues that instead, commissioners need the power to design contracts for providers to meet local needs most effectively in healthcare, employment services, skills and offender management.

Reform says that this requires commissioners to hold non-ring-fenced budgets, with maximum freedom to design contracts to offer to competitive public service markets. It says this will only flourish if commissioning areas are designed to cover geographies requiring similar interventions, and governed by single, integrated and accountable commissioning bodies.

Reform argues that unitary authorities or combined authorities can replace complex local commissioning bodies, such as clinical commissioning groups (CCGs) and police and crime commissioners (PCCs), and be responsible for commissioning services, totalling over £100 billion in 2016-17 spend. It says unitary authorities or combined authorities can allow commissioners to integrate service design, and new local authority structures can cover 38 areas, which have similar healthcare and employment needs.

According to Reform, this transfer of funding from central to local government would be followed by the abolition of NHS England. It says a more devolved state can be completed in 15 years with the right support.

Reform argues for the devolution of over £100 billion of public services spending, including 95 per cent of the NHS’s budget. 38 large councils across England should control this spending to improve outcomes for citizens.