The Local Government Association (LGA) has raised serious concerns about proposals in the forthcoming NHS Modernisation Bill, warning that plans to abolish Healthwatch could undermine accountability and weaken the independent voice of patients across England.
The Bill, announced in the King’s Speech, proposes scrapping the current statutory system for patient and public engagement by disbanding Healthwatch. However, the Government has yet to outline a clear replacement model. Under the proposed approach, NHS organisations and adult social care providers would instead take responsibility for gathering and responding to feedback on their own services.
Representing councils across England, the LGA argues this shift marks a significant departure from the accountability framework put in place following the Francis Report. That framework was designed to ensure independent scrutiny and robust representation of patient experience in health and care services.
According to the LGA, removing a locally rooted, independent voice risks creating both duplication and gaps in oversight. It warns that allowing providers to effectively assess their own performance could erode public confidence and transparency.
There are also concerns about system fragmentation. The LGA highlights that splitting responsibility for patient and public voice across multiple organisations could complicate an already complex landscape, particularly at a time when national policy is focused on integration between health and social care. Such fragmentation, it argues, could widen the longstanding imbalance – or lack of parity of esteem – between the two sectors.
Funding and governance are also key areas of uncertainty. The LGA is calling for urgent clarity on how resources and statutory responsibilities for patient voice will be allocated under the new system. This includes questions around representation within crucial partnership bodies such as Health and Wellbeing Boards and Safeguarding Adults Boards, where Healthwatch currently performs a statutory function.
Cllr Dr Wendy Taylor MBE, Chair of the Local Government Association’s Health and Wellbeing Committee, emphasised the importance of collaboration and clarity in shaping any future model:
“We look forward to working with Government to ensure the NHS Bill is workable and delivers real improvements for local people through neighbourhood health and digital technologies.
“It will be important to align changes within existing statutory arrangements across health and local government including the role of Health and Wellbeing boards, to support joint working and avoid unnecessary complexity.
“The current proposals to disband Healthwatch and allow health and social care services to gather and respond to feedback, rather than being challenged by an independent voice, risks organisations being seen to mark their own homework.
“It could also create confusion and frustration for people who, if drawing on both health and care, will need to approach two different parts of the system to share their views.
“We call on the Government to pause and work with local government and partners to develop a clear and workable model for local patient and public voice that maintains independence, joins up insight across health and social care, and delivers meaningful accountability.”
The LGA’s intervention reflects wider unease across local government and the wider public sector about how reforms will maintain transparency, independence, and public trust. With integration between services remaining a core priority, sector leaders are urging ministers to ensure any changes strengthen – not dilute – mechanisms for listening to and acting on the public’s voice.
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