MPs: Councils will struggle to take on health White Paper role

Cash-strapped local authorities may not have sufficient resource to deliver their added responsibilities set out in the health White Paper, MPs are warning.

This could harm efforts towards integrated health and social care, members of the health select committee said as it met yesterday to examine the proposals.

The White Paper, published last week, said councils would be given responsibility for integrating health and social care locally – through new health and well-being boards – and for public health.

The health select committee questioned health secretary Andrew Lansley on the paper yesterday.

Labour MP Chris Skidmore wondered if it was realistic to ask local authorities to carry out these new roles when they are already having to find savings.

Rosie Cooper, also of Labour, warned of the potential of local authorities “pulling money” out of social care because they were cash-strapped, while the NHS retreated into its own silo.

The White Paper also set out plans for GP consortia to take over responsibility for health commissioning from primary care trusts, which would be abolished by 2013.

Tory MP Nadine Dorries said she could foresee tensions developing between GP consortia and local authorities.

However, health secretary Andrew Lansley said the plans aided integration and described councils’ new role as the most important aspect of the White Paper, and claimed the plans would boost integration, which he said had been held up by PCTs.

Lansley said: “The local authority explicitly has a responsibility to agree with the consortia what the health commissioning should look like and if they don’t agree the local authority is in a position to refer that to the independent reconfiguration panel and through the panel to the secretary of state.”

This body advises ministers on proposals for NHS service change in England that have been contested locally.

Lansley also signalled that existing joint arrangements, such as joint commissioning arrangements, pooled budgets and joint appointments between councils and PCTs, would continue under the new structure, though he was not going to prescribe this.

This follows warnings that replacing PCTs by GP consortia could upset existing joint working arrangements, from the King’s Fund’s senior research fellow for social care, Richard Humphries.

Writing in Community Care this week, Humhpries said: “Replacing 152 PCTs with 500-plus GP collaboratives may well put GPs in the driving seat but, at a stroke, will destroy the co-terminosity of PCT and council boundaries. It could also dissolve the personal chemistry between key local players and will make aligning resources and care planning for individuals’ needs more complex.”

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