Is the integration bandwagon beginning to roll at last?
Scarcely a month goes by without another report on the merits of merging health and local government
Author: Michael Burton, the MJ |
Readers who attended the LGA conference in June will recall that integration seemed to be on every speaker’s lips, irrespective of political complexion.
We can certainly expect ministers and their shadows at the party conferences to extol the virtues of integration as a service enhancing, efficiency issue.
Indeed so passionate is the current (Lib Dem) care minister Norman Lamb about the subject that he told a Localis briefing this week his (presumably civil service-written) speech was ‘rubbish’ and then proceeded to abandon it and speak without notes.
Having all agreed that integration is a good thing, the question is whether managers and politicians can now take it a stage further by implementing it.
Mr Lamb thinks this is now happening. In his address he said opponents of the controversial Health and Social Care Act 2012 had argued it would lead to fragmentation in healthcare.
He said the system was ? and indeed is ? already fragmented anyway but that the new structure of clinical commissioning groups (CCGs) and public health transferred to local government, shored up with a 3.8bn bung for integration, is actually moving in the right direction.
The Department of Health (DoH), taking a leaf out of the Department for Communities and Local Government’s (DCLG) community budgets programme, is currently evaluating the 100-plus bids from local areas to become health and care integration ‘pioneers’.
The DoH is working alongside the DCLG’s Public Service Transformation Network, the successor to the community budgets pilot programme. In Manchester, the combined authority of ten AGMA (Association of Greater Manchester Authorities) members with their 6bn annual spend on health and care, is developing an ambitious strategy involving all the CCGs, the local authorities and the public health directors to create an integrated health strategy across the city region.
The health and wellbeing boards, still in their infancy and yet to prove their potential, are likely nonetheless to have a pivotal scrutiny role in the new system.
Mr Lamb says there is ‘a revolution’ in the way care and health is delivered with local authorities in the vanguard. He may be right and that after years of false starts and this time driven by the demographic timebomb and umpteen graphs of doom, full integration will actually take place within the next decade.