LGA CONFERENCE REPORT
Our colleagues from Public Sector Executive magazine were at this year’s Local Government Group conference in Birmingham, addressed by Health Secretary Andrew Lansley. But it was the panel discussion after his speech which really highlights the current debates over integrated care.
S
ecretary of State for Health Andrew Lansley addressed the LGA confer-
ence in Birmingham on June 30, soon after the NHS Future Forum had reported back.
The interplay between local government and healthcare is becoming ever-more im- portant, from commissioning to social care, and the immediate verdicts of the confer- ence’s expert health panel on Lansley’s speech – and the NHS reforms – are well worth exploring.
Cllr David Rogers, LGA Community Well- being Board chairman and NHS Future Forum member, said: “Very signifi cant progress has been made, quite clearly, on the contents of the Bill, through the listen- ing process and the NHS Future Forum, and indeed on that score I was delighted to be the only elected person who was a mem- ber of the NHS Future Forum. I felt a bit exposed at times but I felt I was there on behalf of all of you and many more council- lors up and down the country, and it was a fascinating and rewarding experience.
“One of the things to be welcomed is the new emphasis on a place-based approach to health and wellbeing. There are two il- lustrations of that; fi rstly the requirement that the commissioning groups should be commissioning services for the whole population area, not as has been the case in the past, simply those on the particular GP’s list.
“Secondly, the expectation that those groups would not normally cross local authority boundaries. If they were to suggest that they wanted to do that they would have to have a very signifi cant set of reasons and justifi ca- tion for wanting to cross the boundaries of the county council or even unitary authori- ties, so that place-based approach is very much welcomed. As is the strength and em- phasis on patient and public involvement, that’s something we are very used to doing, as local authorities, engaging with our com- munities in a variety of ways, and I think we look forward to working with HealthWatch in that regard, as one of the mechanisms of involving our communities in these very im- portant decisions.
“The third thing is the commitment to 10 | national health executive Jul/Aug 11
greater transparency in all aspects of the new structures that are proposed. That governance element is extremely impor- tant, the fact that all of these groups have had to meet in public and there will be much greater transparency is something I think we can all support very strongly.
“One fi nal point is that in relation to Health & Wellbeing Boards, we’ve always argued the case that they should have more teeth, stronger powers, and ultimately the role of signing off the commissioning plans .We’ve almost got there, through the changes and improvements that have been made. There’s a ‘reconciliation process’, if I can call it that, which would seek to resolve any differences.”
Jenny Owen, deputy chief executive of Es- sex County Council, with responsibility for adult social care, said: “The Secretary of State didn’t say very much about the NHS pause or the listening exercise and what happened as a consequence of that. So that’s interesting.
“What he did talk about is a really strong recognition of the role of local government. It’s much stronger in this restructuring of the NHS and White Paper than any I’ve seen previously. The question is will it real- ly be hardwired into the Bill and into what we see, or will it be left to local negotiations – that’s where we often falter.
“The partnership across the whole govern- ment, and not just health and social care, I think is really critical; we could have heard a little bit more about that, for example the importance of housing in improving health and social care outcomes.
“We didn’t hear much about place-shap- ing, but I think it is perhaps implied, but the very strong emphasis on health com- ing back to local government is very much welcome. Andrew Lansley’s point about the impact on wider determinants, I think we’re all extremely well aware of.
“I want to focus on the integration issues between health and social care – it’s re- ally important and I very much welcome the emphasis. But my personal view is that those of us who work in local government have argued strongly for integration for a long time, and much more strongly than colleagues in the NHS. We’ve seen many false dawns on this before, and we’ve even had changes when ministers change, let alone when governments change; we’re go- ing to have to be extremely determined in the future on this one.
“Strategic integration is absolutely key: I don’t think we need to say much more about the Health & Wellbeing Boards’ democratic accountability and so on. I was a bit surprised about the £1m we heard about this morning for development activ-
Cllr David Rogers, LGA Community Wellbeing Board chairman and NHS Future Forum member
© LG Group/Paul Thomas
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