Cancer Care (Supplementary) [1]

Session date: 
December 14, 2017
Question By: 
Len Duvall OBE
Labour Group
Asked Of: 
The Mayor


Len Duvall AM:  Given the answers that you have given, Mr Mayor, and given the focus that you can bring to the issues that Assembly Member Shah brought up, do you not think it is time on the devolution agenda to democratise the NHS in London?  We can be part of the national NHS, and rightly so, but there is something wrong when the focus is not always on tackling the difficult issues.  I am aware of the challenges you have mentioned, the underfunding of the NHS and maybe the difficult decisions, but I would feel safer as a London resident if it was not just left to national Government or a quango such as NHS England to look after the interests of London and take decisions for Londoners.  What do you think about that?  Where are you standing on this issue, especially when we have issues like cancer care being highlighted and some of the inadequacies of their decision‑making?

Supplementary To: 


Answer for Cancer Care (Supplementary) [1]

Answer for Cancer Care (Supplementary) [1]

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  It is a really good question.  Recently I hosted a meeting in City Hall with all of the metropolitan mayors across the country.  It was a very productive meeting and one of the issues raised by the Mayor for Greater Manchester, Andy Burnham, was some of the piloting work they are doing around health and social care.  They have had good conversations with the Government in relation to pooling the budgets.  If you think about it, we still work in silos.  Social care is here and health care is here.  There is a separate issue about the democratic deficit. 


Assembly Member Whittle referred to the National Ambulance Service (NAS) and who they were accountable to.  Question: should they be accountable to a civil servant in NHS England, as good as she may be, to the Secretary of State, who is juggling so many balls and all parts of the country, or to City Hall, who have a bird’s‑eye view of London, know the areas and understand the issues?  You would expect us to say this, but the view from the metro mayors ‑ of all parties, by the way; the majority of the metro mayors are Conservative ‑ was that we need more devolution.


There is a separate conversation about fragmentation of the NHS.  I think you can still keep a National Health Service but have more accountability.  It is not one size fits all.  For example, you could have the NHS centrally deciding what needs to be done but us deciding how it is done.  Just think about the concept of ‑ it is a horrible phrase ‑ bed blocking.  You will be aware of the issue.  Because of social services cuts, people sometimes have to stay longer in hospitals because local authorities cannot provide them with safe places.  Now, they have different budgets and arguably it is not in one person’s interest to help the other.  That is where we could help, in relation to City Hall, the Mayor and the Assembly, through that devolved route, on top of the point you made about the democratic deficit.


Len Duvall AM:  Thank you. 


Jennette Arnold OBE AM (Chair):  Now I can thank you, Mr Mayor, for your answers to the questions?


Sadiq Khan (Mayor of London):  Can I just say this, Chair?  We have had a tough year as a city and I would like to thank the Assembly for your hard work over the last 12 months.  I wish you all a happy Christmas and a good break. 


Jennette Arnold OBE AM (Chair):  The same to you, Mr Mayor.  Thank you.