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Exclusive: Growing 'angst' at London health devo delay

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The government must fulfil its promise to devolve new powers over health to London or risk years of good work being wasted, the boss of the Greater London Authority has warned.

Chancellor Phillip Hammond announced at the March Budget that the government was preparing to sign a second memorandum of understanding on the devolution of powers over health and social care to the capital.

LGC understands the memorandum has been agreed by all involved, including the Department of Health and the Treasury, but is waiting for sign-off by Number 10. It follows the agreement of a first MoU in late 2015 which committed to exploring the potential for devolution through five pilot schemes.

In an interview with LGC, GLA head of paid service Jeff Jacobs said there had been a “huge partnership” at work since the announcement of the pilots including the GLA, London Councils, boroughs, clinical commissioning groups and NHS England.

“There is inevitably a degree of angst that all this work is going on and we can only take it so far. We need the confirmation that was announced at the Budget that there was going to be a second MOU,” he said.

Claire kober

Claire kober

Claire Kober

LGC has also learned that London mayor Sadiq Khan and chair of London Councils Claire Kober (both Lab) wrote to health secretary Jeremy Hunt on 23 June urging him to progress the MoU before parliamentary recess on 20 July.

In it they are understood to say the work of the pilot areas has been supported by around 100 organisations.

“We were disappointed that the planned MoU was unable to happen prior to the general election however both we and London partners hope an early date now can be found for us to sign the MoU.

“This would provide reassurance to London’s health and care system, including hospital trusts, CCGs, boroughs and the voluntary sector, that an ambitious vision for the transformation of the health and care system remains a priority for your government.”

Mr Jacobs told LGC the devolution plans had three elements: integration of health and social care, improved prevention services, and more freedom over the sale and redevelopment of the health estate.

He said work on estates had “carried on motoring” with the creation of the London Estates Board which was looking at improving the primary care estate and using land to deliver more homes for key workers. However, he said incentives, such as the ability to retain capital receipts within London rather than return them to the Treasury, were required for these ambitions to be realised.

“Unless we can get to a position where we can say this partnership can take decisions and is incentivised to take decisions then people will just drift away,” Mr Jacobs warned.

He said it was a similar picture on the integration agenda where new “levers” were required to “make it go further and faster”.

“There’s an awful lot of people been working at this now for a long time and it would be very dispiriting for them if they thought this wasn’t going to happen,” said Mr Jacobs. “Everybody’s holding onto the fact the chancellor announced it so everyone will carry on believing that is genuinely meant until we’re told that it isn’t.”

LGC approached Number 10 to ask about the delay.

A spokesman for the Department of Health, on behalf of the government, said: “We are continuing to work closely with London partners and colleagues across government to finalise this work.”

*The full interview with Jeff Jacobs will be published online and in print later this week


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