The Health Bill and Local Government: difficult times ahead

8th March, 2012 2:59 pm

The Health and Social Care Bill is set to make fundamental changes to the NHS; changes which most within the Labour Party, do not want, and do not support. But, nestled within the Bill are a series of reforms which could have a radical and positive impact for Labour in local government. This leaves Labour authorities with difficult choices: reconciling potential tensions with the Bill at local and national levels, whilst making significant decisions about the future of health and social care in their areas.

At a local level, changes as set out in the Bill have been underway for months; Primary Care Trusts have clustered, many local authorities have adopted shadow Health and Wellbeing Boards and Clinical Commissioning Groups have established. These local level changes have been happening, irrespective of opposition, partly due to timescales, but also because at local level some of the changes set out in the Bill are welcomed by local government – on the Right and the Left. The current system across local government and health is disjointed, and could benefit from change. Labour local authorities recognise this.

Surely Labour councils are right to look at how they can strengthen their role in tackling health inequalities locally? So while this this argument is about values and is highly emotive, we shouldn’t ignore the fact that there is need for change and progress around health and social care in local government – and Labour will want to support their local authorities in making progress on this.

The most significant change proposed for local authorities is the transfer of public health and health improvement responsibilities from PCTs to local government; commissioning of public health services will transfer to local authorities. Many local authorities, including Labour authorities, have long argued that local government should have greater influence over public health. The strengthened role in ensuring greater integrated working between health and all parts of local government is also critical.

By now, most local authorities will have established ‘shadow’ Health and Wellbeing Boards – you don’t need legislation to do this. The Boards will enable local authorities to have substantial influence and responsibility over public health and joint working, and will strengthen the role of local authorities in tackling health inequalities. Because of the tight timetable around implementation of the Bill (April 2013) if local authorities are not already acting, structures would not be in place in time and would risk the National Commissioning Board taking on local commissioning – which would take powers and influence away from the local level. This hasn’t really given a choice but to press ahead with the changes now.

This all sounds positive. Labour have a growing base of power in local government, and these additional responsibilities would give councillors a stronger role and authorities real levers to make reforms locally that could positively change the lives of many. In the run up to the next general election, the Party will want to demonstrate where Labour in local government has made a real difference and local improvement in health and health inequalities. These changes could enable this.

If it is the case that the changes in the Bill for local government are positive and pressing ahead, why is there still so much opposition, even at the local level?

For all of the changes outlined above, you do not need legislation. You don’t need the Bill to promote integrated working, undertake joint commissioning (on an informal basis), or develop joint wellbeing strategies with health professionals. Without the Bill, these provisions for local government alone would be welcome. But, the problem facing Labour local government is that you can’t look at this and the new responsibilities without looking at the wider context.

The Bill will fundamentally change the NHS. Everything regarding health at the local level, including the Health and Wellbeing Boards, will be impacted upon by these changes. For local authorities, making a success of these new responsibilities around health and wellbeing will be much more difficult because of these changes to the NHS. Not least because the National Commissioning Boards will be influenced by rules on competition, which will make integration between these agendas difficult, but also because this fundamentally tests Labour founding principles around the NHS.

Laura Wilkes is a Policy Manager at Local Government Information Unit. She writes here in a personal capacity.

  • Constructive critic

    She makes a very good point a positive engagement will help local government to begin to rebuild a role in this sector which is central to the lives of many voters.

Latest

  • Video Miliband on music, cricket – and the Sinclair ZX Spectrum

    Miliband on music, cricket – and the Sinclair ZX Spectrum

    Ed Miliband sat down with Absolute Radio’s Geoff Lloyd today, and was question on his taste in music, whether or not he’s a geek – and (because there’s an election on) Labour’s immigration policy too. Questions also came in from England Cricket legend Geoff Boycott (a sporting hero of Miliband’s), former snooker player and commentator Willie Thorne – and Ali from the Monsoon curry house in Kentish Town. Miliband also reveals what last made him cry – and dispels some myths about his childhood. […]

    Read more →
  • Featured Labour release their own letter, signed by businesspeople, supporters and zero hours contract workers

    Labour release their own letter, signed by businesspeople, supporters and zero hours contract workers

    After a Tory supporting letter appeared on the front page of this morning’s Telegraph, the Labour Party have tonight released a letter of their own – signed not only by businesspeople and Labour supporters, but also by many on zero hours contracts – backing Labour’s plans, including cracking down on zero hours contracts. Update: The party have started letting people add their names to the letter. The letter has been sent to – and will presumably be splashed on the […]

    Read more →
  • News Unions Labour launches workplace manifesto

    Labour launches workplace manifesto

    Labour’s major announcement today has been on zero hours contracts – but that shouldn’t obscure the unveiling of a much broader set of policies (of which the zero hours contract crackdown was only one) as part of a “workplace manifesto”. The other key policies in the document (which have largely been announced over the past few years, but which are now collated into a single offer for working people) are: Raising the National Minimum Wage to more than £8 Scrapping the […]

    Read more →
  • News Peter Mandelson standing in Manchester: Labour peer in running for top job

    Peter Mandelson standing in Manchester: Labour peer in running for top job

    Former Labour Cabinet minister Peter Mandelson has confirmed that he has put his name forward to be the next chancellor of Manchester University. Mandelson, who was elevated to the House of Lords by Gordon Brown, said he is “excited about what’s happening in Manchester”. The New Labour architect was the minister responsible for universities between 2008 and 2010, and is thought to consider widening participation in Higher Education is one of his proudest achievements of the Labour Government. Although the role is […]

    Read more →
  • News Video Labour winning web wars as over a million watch Martin Freeman election ad online

    Labour winning web wars as over a million watch Martin Freeman election ad online

    Over a million people have watched Labour’s latest election broadcast online in just two days. Labour today confirm that the video, starring Martin Freeman, has been watched more than 1,152,000 times. In contrast, the Conservatives latest broadcast, which also came out on Tuesday, has been seen just 91,000 times – that means Labour’s has been viewed by almost 13 times as many people. Last week, more people engaged with Labour’s Facebook page than any other party, with almost half a […]

    Read more →
Share with your friends










Submit