MP asks: Is the NHS accountable?

“What power have you got? Where did you get it from? In whose interests do you exercise it? To whom are you accountable? And how can we get rid of you?” Those were the questions Tony Benn advised people to ask those in power.I was reminded of this as it was announced the chief executive of the NHS would be leaving her post (not long after the chairman said he was leaving).The NHS has a budget of £170 billion and by any test has a huge amount of power. But is it accountable? Well – in my experience as a MP – not sufficiently given its responsibility.

The biggest challenge for the NHS is cutting waiting lists. NHS England has led on that with mixed success.It has also overseen productivity falling by 20 per cent below levels achieved before the pandemic. Getting back to its previous level would deliver up to £20 billion of benefits each year.That’s why two House of Commons committees called for fresh leadership and a renewed focus on delivery. Another example is access to NHS dentistry. Ensuring people can see a dentist used to be the responsibility of NHS England.I remember many conversations with the procurement team who did get the contract for the Smile practice on King’s Lynn High Street signed but West Norfolk still has one of the lowest number of dentists per population in the country. Then last year responsibility moved to another part of the NHS – NHS Norfolk and Waveney. Have you heard of them?They have a lot of power and a budget of £2 billion a year. Given my mailbag I know how important access to dentists is yet £16.6 million of funding provided by the last government for NHS dentistry went unspent.This year it is expected they will fail to spend around £5-6 million. And it is local people who feel the consequences. Hopefully, within the NHS a different model will be developed under a new chief executive giving more freedom locally while holding them to account, using data, and intervening where things aren’t working.Ultimately, it is the health secretary who is accountable in parliament and publicly for cutting waiting lists and the system should reflect that.Given I am focusing on the NHS, I welcome approval of the Outline Business Case for QEH’s new multi-storey car park by the New Hospital Programme’s Investment Committee.This is an important step in plans for a new QEH and comes shortly after I met the health minister to urge her to make sure these plans move forward. Now I hope to see final stage approval soon to allow work on this key project to start this year.But it’s not just healthcare. Agencies across the public sector are responsible for huge amounts of spending and employ more than 300,000 people.One of the issues I pursued in the last parliament was improving their accountability. When Natural England, for example, can delay the Western Link or conduct a 10-year study into rare snails which is partly responsible for delays to A47 improvements, is the system is working?I say no. The reason I’ve focused on this topic is often constituents contact me about issues which sit with organisations they find impossible to navigate and get answers from.The state needs become more effective. Removing bureaucracy while holding those with responsibility accountable must be the way forward. And I will continue to be available to constituents who need my help in getting action and answers.