Warning over NHS trust power in Wales

Proposed freedoms to allow the integration of NHS trusts and local
health boards in Wales could help cement joint working across
health and social care, ADSS secretary and Pembrokeshire director
of social services Jon Skone has said.

However, Skone, also a local health board member, warned the
proposal could lead to powerful hospital trusts taking control of
funding and health service commissioning to the detriment of
community-based services.

“They [trusts] are powerful organisations, more so than LHBs,”
Skone said. “Developing community health is all right, but what if
the acute sector starts flexing its muscles – everyone will be
concerned that community spending will be squeezed.”

As part of its review of arm’s-length government bodies, the Welsh
assembly announced it would consider applications for the
integration of NHS trusts and local health boards in coterminous
areas where there were benefits for patients.

LHBs took over health authority responsibilities for funding,
planning and commissioning decisions on the NHS in April 2003. They
are responsible for establishing local health and well-being
strategies, and each council’s LHB has social services
representation on it.

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