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LGA - Vital councils at heart of health service shake-up

Summary: Councils are ideally placed to take the pressure off GPs in the Coalition's health care shake-up by ensuring vulnerable children, dementia sufferers, people with learning difficulties and the homeless get the services they need.

This is the message from the Local Government Association, which represents more than 350 councils across England and Wales, as it presents its submission on the Government’s Health White Paper.

It calls for town halls, not just doctors, to play a key role in commissioning services, particularly in the areas in which they have expertise – mental health; health and wellbeing of homeless people; long-term conditions; drug and alcohol dependency; dementia services; services for children and young people; services for people with learning disabilities; HIV/AIDS services; carers’ services, older people’s services and free nursing care.

Other key messages include:

•The increased public health role for local government is strongly supported. Many councils are already putting effort, resources and imagination into improving the health and wellbeing of their communities.

•The need to create strong and focused Health and Wellbeing Boards to provide effective local leadership and coordination of services for everyone. These must be given a statutory footing and be seen as equal to GP consortia and the National Commissioning Board.

•The importance of scrutiny of the National Commissioning Board, Health and Wellbeing Boards and GP consortia, and need for them to be locally accountable.

•Urgent clarification is needed on funding of patient and public involvement next year. Funding for Local Involvement Networks runs out in March, but the replacement Health Watch does not go live until April 2012.

Cllr David Rogers, Chairman of the Local Government Association’s Community Wellbeing Board, said:

“This shake-up is an opportunity which, if handled properly with a clear allocation of roles and good communication between councils, GPs and NHS bodies, could be a real shot in the arm for the health.

“But councils need to be at the heart of commissioning, especially in the areas they have experience and expertise in like so-called ‘Cinderella services’ for the vulnerable. GPs are inexperienced here and there’s a real risk they may not see the incentive of commissioning services where success isn’t easy to measure, or might outsource commissioning for these groups, breaking a vital link between an individual’s health and social care services.

“Decisions on where to spend money and commission services need to be taken locally. Councils know their residents’ needs best and using available funding as they see fit will keep people healthier and reduce the burden on the health service.

“Health and wellbeing is much more than just doctors and nurses. The foundations of local government in the 19th Century were in the need to beat typhoid, cholera, poverty and poor housing. The challenges may have changed but councils are still best placed to improve their residents’ health in many ways, whether it be promoting nutritious food and exercise, or helping people quit smoking or excessive drinking."

Source: Local Government Association

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