Ensuring Public Services Maximise the Benefits of UK federalisation
Transition Objectives
Public services are at the heart of everyday life, and their stability during transition is paramount. This page explains how the NHS, policing, education, transport, environmental enforcement, and other public services would be impacted by the federal model — with operational delivery devolved to State Departments and national policy retained at the Federal level.
It also sets out how the civil service would transition safely and smoothly, with staff reassigned to Federal or State roles under protected employment rights. The goal is a more efficient, accountable, and locally responsive system that maintains continuity throughout the transition.
1. Healthcare & Socialcare
Whilst quality of English NHS Care is amongst the best on Europe, Its Administrative access is the least efficient – sometimes feeling like an insurmountable challenge. Improving its efficiency and accountability thus presents a major objective of the 7States Programme.
The Federal Government would retain responsibility for Medical Research, UK Strategic Planning, Data Architectures and NHS Staff National PayScales, Also for National Standards, Healthcare Advice and assessment of Medical Efficacy – but leaving operational affordability to individual States. Assurance of Care Continuity would form part of the NHS Transition Plan.
At the Federal level, NHS England (part of the Department of Health) becomes reorganised into seven State‑level NHS Departments for purposes of Service Funding and delivery. Each State Department responsible for Hospitals, GPs, Mental Health, and Social Care within its area The Federation would therefore perform the same roles for the States of Scotland and Wales – so all seven States become serviced equally.
Each individual State has full democratic autonomy to fund and run Healthcare any way it chooses – by Personal Taxation and/or NI and/or by other means. Free to assess and migrate to other models – such as used in the Netherlands The same approach would apply for Social Care (in both cases being subject to the electoral will of The People – and the aforementioned NHS Standards).
Each State would manage geographical areas aligned with the original NHS Regional Structure (disbanded in 1996 – now to be re-established) that provides a finer level of healthcare commissioning granularity, These being:
| Healthcare Department | NHS Care Delivery Regions |
| Scotland | Scotland (subject to structural consultation) |
| Wales | Wales (subject to structural consultation) |
| Northern England | Northern, Yorkshire, Mersey, North Western |
| Central England | Trent, West Midlands |
| South‑East England | East Anglian, NW Thames, NE Thames, SW Thames, SE Thames |
| South‑West England | Wessex, South Western |
| Greater London | London quadrants devolved to the four Thames RHAs |
| Federally Managed | Semi-Autonomous Teaching Hospitals (Page 5.3) |
Each State and Care Delivery Region would have a formally established assessment rating of the standard of care provided. Enabling standards to be improved by better performing States becoming models for others.
As for all Economic Sectors, public accountability for Healthcare and Socialcare delivery in each State falls under the remit of a Sector Management Group forming part of its system of Unified Democracy as previously described (Page 4).
2. Policing & Public Safety
Policing becomes a State responsibility, with each State operating its own unified police force. The Metropolitan Police becomes the London State Police. Federal Government retains responsibility for national security, intelligence, and counter‑terrorism.
3. Education
Schools, colleges, and universities become State‑level responsibilities (other than some autonomous universities previously described on page 5.3). Curriculum standards remain Federal, ensuring national consistency while allowing States to tailor delivery to local needs.
4. Transport
Intrastate transport — buses, local rail, roads — becomes State‑managed. Inter‑state rail and national transport strategy remain Federal. TfL becomes the London State Transport Agency (but could retain its current name).
5. Water, Environment & Rural Affairs
The Federal Government (DEFRA) retains responsibility for national strategic planning (as for water supplies and food sustainability), environmental standards and climate policy. State‑level Departments (equivalent to DEFRA at the operational level) manage farming, fisheries, land use, water management, waste, and environmental enforcement within their boundaries.
6. Civil Service Transition
Operational civil servants transfer to State Departments, while Policy civil servants remain in Federal Ministries. All staff would retain employment rights, pensions, and contracts under TUPE‑equivalent protections. Federal and State Civil Service Commissions oversee recruitment, promotion, and professional standards.
Summary – Public Services & Civil Service Impacts
The reorganisation of public services and the civil service is central to delivering a smooth and secure transition. By devolving operational delivery to State Departments while retaining national policy at the Federal level, the UK achieves a more accountable, efficient, and locally responsive system without disrupting essential services. These reforms lay the groundwork for a modern, service‑focused federation that is capable of meeting the needs of citizens across all seven States.
