The Care Necessities – Debating the NHS/local government relationship

Author: Localis   |  

Localis was thrilled to host a panel speaking event at the Conservative Party Conference on Tuesday, the 1st of October.

Speakers at this event were:

• Rt Hon Stephen Dorrell MP, Chair of the Health Select Committee and Former Secretary of State of Health
• Dr Daniel Poulter MP, Health Minister
• Cllr Paul Carter, Leader, Kent County Council

Facing a full audience, the three experts from local and national government all agreed that the prognosis for the relationship between the NHS and local government was better than expected. However, interestingly, views varied regarding the pace of change this relationship could tolerate and who should make the effort in keeping its positive prognosis on track.

Rt Hon Stephen Dorrell MP admitted that local government’s role in the integration agenda was an unintended consequence of the Health and Social Care Act but he argued the debate had now “moved on” to acceptance. He described changing demands in which more frequently, the caricature of a patient “does not present for a cure” but “signs up for the rest of their lives” so that a quality service for these patients is one which is predominantly care based, with healthcare responding when needed. This warrants local government deciding how resources in “by far the largest public service” are distributed. He argued that maintaining the healthy relationship between the NHS and local government requires local communities to “grasp the nettle for reshaping” these services themselves, rather than relying on statutory changes.

Councillor Paul Carter acknowledged Stephen’s views but argued it was more imperative for the future health of the integration agenda that the NHS and government provide a clear vision of “what good looks like” to win the hearts and minds of GP’s and health practitioners. Such a vision would improve the co-operation between CCG’s and local government. Councillor Carter argued this was key to Kent County Council’s success in transforming an initially hostile new relationship, “fraught with danger” to an optimistic acceptance on the effectiveness of integration in healthcare. He also encouraged urgency from central government in providing “forward funding” for community health and social care schemes, which would prevent overstretching acute health services in the future. Finally, he positioned local government as urging a “revolution” in the pace of these reforms.

Health minister Dr Dan Poulter MP disagreed with Councillor Carter’s invocation for a revolution in the pace of national funding, citing that it may have unforeseen consequences. The minister reminded the audience of evolutionary changes government was supporting to build a picture of what goods look like, such as holistic data collection and the current pilot scheme into innovative solutions to integrative challenges. He argued that while evidence was being collected, government right now was committed to £3.8bn in priming money to smooth over the transition. In closing, he remained adamant that the only “key message” required for health practitioners was that this is “not a situation of choice about integration”.

The hashtag for this event was: #localiscare