The department of health has failed to convince local government
leaders and the voluntary sector that care trusts will remain truly
voluntary partnership arrangements and will not lead to an NHS
takeover, writes Lauren Revans.
Despite denials last week by the department of health’s
joint lead on care trusts Carole Bell that an NHS takeover was “not
the intention” of the decision to base the model within the NHS,
she failed to allay fears renewed by recent comments from health
secretary Alan Milburn.
John Ransford, Local Government Association head of social
affairs, health and housing, said: “I keep worrying that care
trusts are being elevated into something they are certainly
“Care trusts are very important. The LGA are for them where they
work and where they are the best solution to local issues. But we
get worried when we hear the secretary of state saying he wants to
see care trusts in every area. We only want to see it where
it’s best for dealing with their issues.”
Ransford said users and voluntary organisations representing
users were worried that the doh appeared to have invented a new
word, ‘healthandsocialcare’, which implied they already
saw the two systems as one.
“If the agenda is to take social care into health, I wish
someone would just say it so we can have an argument about it,”
Ransford said. “We do not want it to be done by stealth.”
But, speaking at a conference on the way forward for health and
social services, Bell insisted that care trusts must be seen within
a broad range of initiatives and agendas. “Despite all the
criticisms being levelled at us, what we aren’t doing is
saying there’s only one way of doing this,” she said.
She went on to remind delegates that, although the power to
impose compulsory care trusts had been lost during the
parliamentary process, the secretary of state still retained the
power to direct the use of partnership arrangements where services
Bell said the care trust application process ensured that only
“the most robust proposals are coming forward”. However, the number
of demonstrator sites has fallen once more following the decision
by south-east Hertfordshire to withdraw for the time being. A west
Surrey partnership on the original list of demonstrator sites
published in July, disappeared in September.
Bell told the Harrogate Management Centre conference care trusts
could have a single budget with separate budget headings, and the
power to transfer money across “according to the board when areas
of pressure are discovered”.