Mr Johnson has been the least precise. His announcement of a year long review of the NHS talks of it ending with improved “local accountability” and “community responsiveness” – which could mean anything.

Hazel Blears, secretary of state for local government, has gone further, stating that “we need to be thinking about giving local people more control over their NHS” and that she will be discussing with colleagues “how we make that happen”.

But Jack Straw, the cabinet minister in charge of constitutional reform, has gone furthest, saying that too much power has been handed over to “unelected health service quangos”, power that now needs to be “brought back within the elected field”.

This is bizarre. For two decades now both Conservative and Labour ministers have demonstrated that none of them trusts local government an inch. Local authorities have seen their powers in education, planning and much else removed, cribbed or constrained.

They have been inspected, performance managed and capped close to death. And administration after administration has failed to address the issue that really poisons the relationship between central and local government – namely local government finance and its massive over-reliance on central government funding.

Yet ministers who even now believe that local authorities cannot be trusted with big planning decisions somehow seem to believe they could do a good job of commissioning £90bn worth of NHS care.

For the NHS, such proposals ignore the fact that the labour government already has a policy for reform that needs driving through and completing; that the last thing the service needs is another round of structural change; and that there is no evidence that involving local government would make the service more responsive – history suggests the opposite.

The idea would also be unlikely to solve the problem it might be aimed at: “postcode prescribing”, in which variation in local NHS services has proved unpopular. More likely it would – almost by definition – make variation greater.

It also ignores the lessons of history – that representation over how services should be provided, without the ability to raise money to affect that, is a recipe for conflict. Back in the 1970s and 1980s councillors held between a third and a half of the seats on local health authorities.

Without the ability to raise health service money locally – “representation without taxation” – the result was endless wars over whether central government was providing enough money, rather than a concentration on services. In places, service change became paralysed as health authorities refused to balance the books.

That culminated in the government having to send commissioners to the giant health authority that covered the three great teaching hospitals of Guy’s, St Thomas’s and King’s, an experience so bruising, and so damaging for patient care, that no sane person would ever want to see it repeated.

This is not to say that local government and the NHS do not need to work more closely, particularly over social care and public health. But they are already beginning to. Local authority overview and scrutiny committees can already refer big services changes to an independent panel for evaluation.

NHS bodies are about to be required to co-operate in local authority area plans. In some places, the primary care trust chief executive and local social services director has become the same person. In Herefordshire, the council chief executive and primary care trust chief executive will become a joint post.

Such organic initiatives may help make services what they need to be: more nimble and responsive. Imposing some form of elected control – whether via local government or through direct election to primary care trusts, is likely to do the opposite.

Local government has a big enough agenda in local regeneration – and now it appears, once again, in housing – without lumbering it with the health service.

On the health service, the labour government needs to complete its current reforms and see if they work – not divert energy into further changes that would do far more harm than good.

The writer Nicholas Timmins is the FT’s public policy editor

http://www.ft.com/cms/s/cd351e08-3334-11dc-a9e8-0000779fd2ac.html