Local authorities must be at the heart of any strategy for integrated care
Author: Gwilym Tudor Jones, in the Guardian |
For decades, closer integration between health and social care has been the holy grail of health policy. Successive governments have wanted it to happen. A newly elected Labour government in 1997 vowed to “break down the Berlin Wall” between health and social care.
But despite such efforts, the voyage continues. As Norman Lamb, the minister for care, put it: “People are falling through the cracks ? having to retell their story every time they encounter a new service.”
Bucking the trend of previous governments that were adamant about driving integration from the centre through top-down targets, the coalition government has assumed a decidedly localist tack.
Through the newly formed health and wellbeing boards, councils have been told to end the institutional divide between health and social care by 2018.
But will the government’s recasting of the relationship between the NHS and local government really herald a new era of opportunity for integrated health and care services?
That’s precisely what we asked a group of council leaders, MPs and health professionals as they gathered about a round table at a recent event we organised.
And the good news is that the leaders present conveyed a near feverish excitement about their enhanced powers, hailing the homecoming of public health to local government after years in the wilderness. For one councillor, health and wellbeing boards are a crucible for integration in local authorities, uniquely positioned to unite local councils, children’s services, adult social care, public health, patients and the public, delivering co-ordinated, personalised care. For another, the age of working in silos is over.
Public health professionals, too, expressed a sense of relief at being released from the shackles of NHS control and the opportunity ? long awaited ? to commission freely in response to local needs.
Not that everything in the garden is rosy: some doubts were raised over whether, notwithstanding the government’s aims, the reforms will provide the locally responsive and integrated care many hope for. In particular, naysayers fear that, lacking any real statutory clout, health and wellbeing boards are in danger of becoming well-meaning talking shops, while clinical commissioning groups morph back into mini primary care trusts.
The holy grail of integrated health and social care designed around the needs of the person is destined to remain a distant dream unless, argue some within local government, the reform is taken to its logical, localist conclusion, with local authorities assuming responsibility for all health commissioning.
Such a move, they say, could open the door to greater local responsiveness, democratic accountability and, most important of all, genuine integration of health and social care.
Gwilym Tudor Jones is a research fellow at Localis, the localism and local government thinktank.
Click here to read original article.