Although the health needs of the UK have changed dramatically since the inception of the NHS, our health-care system remains largely unchanged. This leaves us with a National Health Service that is designed to meet the needs of a society that no longer exists. There is wide agreement that the NHS needs to prioritise preventative care to take the strain off front-line services.
In the 20th century, before the NHS, many urban local councils started off as “local boards of health”, then becoming district councils, and local authorities. At each stage of reorganisation these bodies lost a little bit more of their role in health until today the care they mostly deliver is adult social care and children’s services; any other health care is delivered by other bodies.
The Health and Social Care Act has placed a large emphasis on local government driving improvements in public health with a renewed focus on prevention. With responsibility for public health having being transferred from the NHS to local government on 1 April this year, we can expect our health landscape to change quite dramatically. Local government seems to be rising to the challenge and coming up with some innovative solutions but it is difficult to see the scale of its aspiration to drive change and deliver innovative health services.
Labour is proposing a single holistic system, integrating physical, mental and social care. To deliver this, local government would hold an integrated budget for most health and social care services – likely to amount to about £89bn. But are local governments really capable of commissioning and delivering these ambitious plans?
22 July 2013