Councils to be granted powers over public health

Local authorities will be given statutory responsibility for bringing health and social care together under radical NHS reforms announced by health secretary Andrew Lansley today.

The health White Paper revealed that both primary care trusts and strategic health authorities would be scrapped by 2013.

Consortia of GP practices will take on responsibility for commissioning most health services from PCTs while councils will take on PCTs’ public health functions and be charged with leading the integration of health and social care locally.

Care minister Paul Burstow said: “Local authorities will be given access to resources that will be reallocated to the public health aspect of their new role.” However, he denied that there would be a substantial transfer of management costs from PCTs to local authorities.

He told Community Care: “What this has done is deepen and strengthen the relationships so the GPs in their consortia, local authorities, social services, children’s services and public health responsibilities will come together in one place, working together to deliver the best system, not from the point of view of ministers, but to meet the needs of the local population.”

The White Paper states: “Building on the power of the local authority to promote local well-being, we will establish new statutory arrangements within local authorities – which will be established as ‘health and well-being boards’ or within existing strategic partnerships.” It said the boards, to be established by April 2012, would “take on the function of joining up the commissioning of local NHS services, social care and health improvement”.

Richard Jones, president of the Association of Directors of Adult Social Services, said the White Paper offered an increased role for local government and a renewed focus on the integration of social care services. “The paper is a positive starting point,” he added.

Local authorities will also jointly appoint directors of public health with a national Public Health Service, with directors given control of ring-fenced public health budgets weighted according to the wealth of the local area.

They will have to deliver against a set of between five and 10 quality assurance statements, designed to apply across all health and social care services.

However, the powers of the secretary of state for health will be curtailed to stop “micromanagement” of the day-to-day running of health and social care services.

GP consortia will commission most health services with a few exceptions, including dentistry, community pharmacy and large-scale specialist services.

They will be under a duty to work in partnership with local authorities and will be accountable to an NHS commissioning board which will set standards for services.

Lord Victor Adebowale, chief executive of social care provider Turning Point, said: “Greater fluidity between services not only increases quality and outcomes but has been evidenced to deliver significant cost-savings. We therefore hope that today’s rhetoric will become a reality.”

The government also announced a wide-ranging review of health and social care regulation today with a view towards significantly reducing the burdens on commissioners and providers.

The White Paper will also mean a change in the role of the Social Care Institute for Excellence, with some of its functions in promoting and disseminating good practice in social care being transferred to a beefed-up National Institute for Health and Clinical Excellence (Nice).

White Paper key points

– A consumer organisation, HealthWatch, will be established within the Care Quality Commission with local branches replacing local improvement partnerships

– There will be an increased role for CQC in monitoring the quality of social care providers

– The government will introduce a choice of providers for some mental health patients from April 2011

– Personal health budgets to be piloted and evaluated before widespread roll-out in 2012

– Monitor, the economic regulator for health, will have its powers extended to govern social care providers

– NHS staff will be encouraged to take control of services as social enterprises. The white paper said it “aims to create the largest social enterprise sector in the world”

– A management budget reduction of 45% from NHS services will be used to fund better care.

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