[PDF] Devo-then, devo-now : What can the history of the NHS tell us about localism and devolution in health and care?

Institute for Public Policy Research
Institute for Public Policy Research (IPPR)
Publication date:
01 August 2017


Over the past few decades a recurrent theme in public policy discourse has been the desire to decentralise economic, public service and democratic power within the UK, and more recently within England.

These initiatives – and in particular the devo-health ‘experiment’ in Greater Manchester – throw up a range of questions for policy makers and the public. How much power should be passed down to the local level within health and care? Who should they be passed down to? What should local leaders do with these new freedoms? Will this process lead to the democratisation of health and care decisions and speed up reform? Or, will it hinder the ability to deliver an efficient and effective health and care system?

It is our hope that this set of essays, authored by leading historians of both the health and care system and the decentralisation of public services, will help shed light on some of the debates, feeding into the ongoing discussions at national and local level about the role of localism and centralisation within health and care. We hope you find them both interesting and informative.