As part of the Health and Social Care Bill the Secretary of State (for the time being) announced the formation of… Healthwatch. Healthwatch is going to bring about, in Lansley’s words…
…real local democratic accountability and legitimacy to the NHS for the first time in 40 years.
Well, as someone who very much favours democracy, that sounded pretty damned good to me, so I have been watching and waiting these last 12 months or so for details of Healthwatch. Who will they be? How do you get to be a health watcher? What functions will health watchers have?
Sadly, the questions mount, but very few answers seem to have emerged. As far as I can gather Healthwatch will be a body commissioned by the local authority to carry out functions such as… acting as the consumer champion for the local community, and listening to the voice of local people, and it will be ‘representative’ of local people.
All of which sounds very nice, with lots of ‘local’ references, but what happened to the democratic bit… and how and to whom are they accountable? Who will appoint my local consumer champion? Will we have local ballots to determine who these people are, and meetings held in public where we will be able to challenge them? The answer I’m getting so far appears to be…. buggered if I know, councillor, but I very much doubt it!
Of course, as with so much of this ‘Big Society’ nonsense, what we are likely to be landed with is a self-selecting group of the unelected and unelectable acting as self-selected ‘people’s champions’. If they can fit it in somewhere in between sitting on the board of their own housing association, setting up their own ‘free schools’, running the local library and bidding to take over their local post office!
When it comes to democratic accountability I always think Tony Benn’s five tests of democracy are worth considering…
1. What power have you got?
2. Where did you get it from?
3. In whose interest do you exercise it?
4. To whom are you accountable?
(and most important of all)
5. How can we get rid of you?
Only democracy gives us that right. That is why no-one in power likes democracy – and that is why every generation must struggle to win it and keep it.
So when Healthwatch comes to a town near you, do take the time to… ask them the five questions!