Department of Health moots greater role for councils at primary care trusts

Officials charged with increasing social care’s influence over health commissioning are considering giving councils seats on primary care trust boards, according to a government adviser.

Department of Health adviser Tony Elson told delegates that officials had hinted at the measure but had not drawn up firm proposals.

Elson, a former council chief executive, said he was encouraging the DH to extend its enthusiasm for joint appointments between councils and PCTs beyond directors of public health to other posts, to improve integration.

But he said the DH struggled to understand the diversity of local government as shown by its recent promise to create an executive member with responsibility for all council adult services.

He said: “It’s about the inability of a centralised department to understand the diversity of local government and how it thinks it can tell councils how to organise their management structures.”

The conference also heard that NHS vested interests were stopping the DH from driving forward the health and social care white paper’s agenda of shifting services out of hospitals into preventive care.

Professor Gerald Wistow, visiting professor in social policy at the London School of Economics, said the white paper agenda had “gone quiet” because of its radical implications for the distribution of power in care services.

He said: “It’s much easier to put it on the wait and see pile than the action today pile.” For instance, Wistow said, plans to bring together the totality of health and adult social care budgets, touted by care services minister Liam Byrne, had been dropped because “it is not in the interests of the NHS”.