In my time as Member of Parliament for Truro and Falmouth we have continued to see record levels of investment into our NHS and local health services here in Cornwall. But alongside the investment, we need to see the money spent well and wisely, in ways that will have a direct positive and tangible impact on service users. Something I have been thinking about recently is on who is accountable for the decisions made on NHS spending, these colossal amounts of money that can make a real difference to our health services.

In Cornwall Council, for example, the ruling administration, made up of democratically elected councillors, forms a Cabinet, chosen by the Leader of Cornwall Council, one of whom has responsibility for adult social care. All are accountable to the people who elected them.

But in the NHS, the decision-making hierarchy is very different. In Cornwall, in recent years we have had the introduction of an Integrated Care Board, made up of health professionals, to encourage better and more joined up working from the various local NHS organisations.

But Integrated Care Boards remain accountable to NHS England, a massive and inflexible organisation, and this in itself places limitations on how flexible and nimble local budgets in Cornwall can be to local needs. But everywhere is different, the needs for Cornwall, a largely rural and sparsely populated area, compared to our cities, could not be more different. Just in recent years it has been a struggle for myself and my MP colleagues to argue the positive case to the NHS for projects such as the Tri Service Safety Officers, who serve their communities across Cornwall, to make progress because of the perceived lack of flexibility and accountability of the NHS decision makers.

One potential solution to this could be more devolved powers locally but also putting more democratic accountability on to our NHS. One option would be to have elected health commissioners should each NHS Trust – as an equivalent to the Police and Crime Commissioners. Another would be to transfer responsibility for the NHS to unitary councils like Cornwall Council.

Obviously being an elected person responsible for NHS and health decisions in this manner would be a high profile and very involved role, but the big positive would be that they would be accountable, to the people, for the decisions that they make and the direction they take the NHS, much as us MPs are responsible for broader decisions nationally in Parliament. I would love to hear your thoughts on whether you think this would be a positive move, or your alternatives.

Please get in touch with me by email at [email protected], or by telephone on 01872 229698. My regular constituency advice surgeries are held at my office, so please do get in touch should you wish to meet me about any matters that I can be of assistance with.

Cherilyn Mackrory, Conservative MP for Truro and Falmouth