Holyrood debates democratically elected health boards

In a move aimed at reducing a perceived “democratic deficit” in the provision of health care, the Scottish Parliament has assented to support the key principles of the Health Boards Bill.

The bill, which has the support of both Labour and the Conservatives, was debated and backed by the Holyrood parliament on 15 January. The vote means the first draft of the bill has now been approved, and may move forward in the consultation process.

Cabinet Secretary for health and wellbeing, Nicola Sturgeon, said: "Accountability, transparency and responsiveness must be at the very heart of public sector decision-making and direct elections to health boards are an obvious and logical way of achieving this.”

If passed, the bill would see health boards consisting of a majority of elected members, both local councillors and directly elected officials. This would be achieved by way of elections every four years, using the form of proportional representation known as single transferable vote, and with a reduced voting age of 16.

Before the proposed scheme is rolled out nationwide, at the potential cost of £20m, there will be two pilot elections staged in order to asses its viability. The pilots are to last for a period of up to seven years.

Despite the bill’s apparently laudable aim of further democratising a public institution, some have expressed concerns. Tory shadow cabinet secretary for health and wellbeing, Mary Scanlon, said: "The main concern is the fact that these funds will come from front line NHS services." She also expressed concerns about the potential “politicisation” of health boards.

The City of Edinburgh Council has been largely supportive of the bill. A spokesperson said: “The Council understands the need for improved transparency, accountability and scrutiny in public decision making and welcomes the position of the Scottish Government to encourage greater public and patient involvement in the planning and delivery of local NHS services in Scotland.”

The council did, however, offer some cautionary words: “enhancing and strengthening current arrangements would be a more cost-effective approach to the accountability and control of NHS Boards.”

Liberal Democrat Shadow Health Secretary, Ross Finnie, has also expressed concerns regarding the specifics of the bill: "Liberal Democrats believe we should be driving for full integration of community health partnerships. Accordingly, we have concerns that pitting majority-elected Health Boards against elected local councils will not help to achieve this end.”

The bill will now progress to the next evaluation stage of parliamentary scrutiny.