What’s the point of devolution when it doesn’t cover the NHS? - Yorkshire Post Letters

From: Gareth Robson, Beckenham.

There it is again - the postcode lottery chorus. Page two of The Yorkshire Post (August 11) quotes the Care and Support Alliance demanding nationally-driven improvement in social care because of large differences in support between regions.

Oh but wait - we're in a devolution cycle at the moment, surely mayors should be tackling this, each of them focusing on making improvements in their ‘mayoral strategic authority’ such as YONOYOCA (the York and North Yorkshire alphabet soup).

But look again - no, they can't, because apart from Greater Manchester the mayors have little or no influence over the NHS which is devolved and structured along completely different geographic and operational topography.

The kind of people who become senior politicians just don't have the type of brains to grasp how to organise operational systems like this. They don't see that having different structures for the NHS, police, water, fire and civil defence defeats any attempt at coordination and accountability.

That's why we have had decades of failed reorganisations of local government in England without anyone calling a halt to it and making clear that without proper elected governments and civil services for large regions, there is just no point to any more of the fatuous tinkering we have been subjected to for most of our living memory.

Everything bar defence, national infrastructure and international treaties should be decided by regional governments - North; Midlands; South-East; South-West. We need no MPs for Scotland, Wales or Northern Ireland to be sat in Parliament; instead, we just need to give their First Minister and Deputy an automatic seat on the national cabinet.

With regional governments in place we wouldn't need a central House of Commons; just a cabinet drawn from the regional parliaments and subject to their control. We wouldn't need 600+ fossils in the House of Lords either. With them all gone we could go about refurbishing and selling off the Palace of Westminster instead of the cripplingly expensive task of refurbishing it whilst it remains in operation.

MPs in regional parliaments would work mostly online, based at home with their families and loved ones instead of getting up to all sorts, at taxpayers' expense, on their regular excursions to London. Andy Burnham says he wants to rewire the UK state - music to my ears, provided he is going to be sufficiently radical about it.