ScullyPaul Scully is the former Leader of the Opposition in the London Borough of Sutton, is working on a report, Tomorrow’s Councillors, which is investigating how Big Society and localism is impacting on the role of councillors. He wants to see local accountability come to the NHS

A cottage industry has been built up over the last few years with any number of local government commentators keen to charge you a hefty sum to allow them to define Localism and the Big Society for you. The Communities and Local Government Select Committee without a hint of irony spent a disproportionate amount of time expressing concern that the Government hadn’t defined localism clearly enough and people have scratched their heads about the Big Society and pigeon-holed it as merely a new phrase for volunteering.

Now whatever your views on localism, I hope that we can agree on one aspect: it’s all about making decisions closer to your Town Hall, not in Whitehall. Yes, Eric Pickles may appear on the Daily Politics complaining about the actions of some local authorities but on the whole it’s still left to the local authority to make their own decisions and to be accountable for them. The Secretary of State doesn’t have to devolve his opinion along with the decision-making process.

However, in Sutton one particular decision is falling through the cracks; the scrapping of the Accident & Emergency and Maternity units and the reassessment of Children’s Services provided at St Helier Hospital in Carshalton under the auspices of a review called ‘Better Services, Better Value’. Residents are up in arms about the doubling of their journey times in an emergency as they are forced to go to Croydon, Tooting or Kingston. This move is at a time when A&E services in Sutton have seen an unprecedented increase in demand.

You can follow our campaign against these proposed changes via our website As you’ll see the hospital has been there for generations of local residents since the Luftwaffe used it as a landmark to line up for bombing raids. Now residents are lining up to support the hospital.

My main question for this article is when is a local decision really local? It was made in a meeting room somewhere in the vicinity by a 60-strong panel. None of the MPs representing affected areas were present and the only local councillor on the panel is a GP who was there representing his Clinical Commissioning Group.

The 18 ‘Public/Patient/Carer/Community Representatives’ have been promised anonymity and so their names will not be published. Therefore I have no idea if my community was represented and if so, by whom? One of the constituencies most affected, Sutton & Cheam, is represented by Paul Burstow MP, a Government Minister in the Department of Health. In expressing his inability to affect the decision he defaults to the usual Liberal Democrat party trick of wringing his hands whilst simultaneously sitting on them.

Surely localism can only work as a valid means of decision making if local people feel that they can influence decisions made in a transparent way by people who are accountable. That does not need to be politicians but people who will be affected need to have confidence in those directing changes. Accountability does not come easily to the National Health Service and I am leading the crowd in waving goodbye to Primary Care Trusts, having seen at first hand the waste arising from stifling bureaucracy in Sutton & Merton’s PCT, but the replacement must not be a cluster of smaller bureaucracies just as obfuscating and impenetrable as their predecessors.

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