Yesterday I argued strongly that given the central fact that the NHS is paid for out of national taxation, and given this is key to the principles of the NHS that the public want to keep, the role of local government should not be to have an executive say in the commissioning of health care. NHS spending is 100% national resources from taxation and accountability should be with central and not local government.

However national accountability does need to change from the existing system because there have been changes in how the NHS is organised.