Councils demand "urgent clarification" on funding for health overhaul

Town hall chiefs are calling for urgent clarification of the funding arrangements for measures contained in the Health and Social Care Bill, which was published yesterday.

The Local Government Association also expressed concern at the speed at which the reforms were being pushed through, warning that the new system may not be ready in 2013.

Cllr David Rogers, chairman of the LGA’s community wellbeing board, said: “The government health reforms will fundamentally alter the landscape of healthcare and pose significant challenges for delivery. We are pleased to see many of local government’s consultation proposals seem to have been included in this bill.

“However, it is uncertain whether funding will be sufficient and we seek urgent clarification. It appears councils could receive less than the new central body Public Health England, but have much more responsibility.”

Cllr Rogers said the LGA would thoroughly scrutinise the Bill to ensure it mirrors the government’s stated intention of freeing up councils and communities to decide how best to improve health and wellbeing locally, without needless interference from the centre.

“Town halls fought hard against plans to scrap separate health overview and scrutiny committees, and their arguments have hit home,” he added. “Extending formal council scrutiny to cover all NHS-funded services is a positive move, as is the decision to give health and wellbeing boards powers to make sure NHS commissioners work together with town halls to improve the health of their communities. But involvement must extend through all tiers of local government, from district to unitary.”

Cllr Rogers predicted that the key to the reform’s success would be local leadership and accountability. “Local government called for the new Health and Wellbeing Boards to be given teeth and put on a statutory footing and this appears to have happened, though we will keep pushing to make sure it becomes reality.”

But he revealed that councils were concerned by the speed at which such complex reorganisation was being pushed through. “That calls to speed up the introduction of wellbeing boards and phase in new GP consortia with pilot schemes have been acted on is reassuring,” he suggested. “And the move to make GP commissioning decisions more transparent can only be a good thing.”

The government insisted the Health and Social Care Bill would lead to “better quality care, more choice and improved outcomes for patients, as well as long-term financial savings for the NHS, which will be available for reinvestment to improve care”.

There will – for the first time – be a defined legal duty for the NHS and the whole care system to improve continuously the quality of patient care in the areas of effectiveness, safety, and patient experience.

Key proposals include:

• handing responsibility for commissioning to GP-led groups
• establishing HealthWatch and local health and wellbeing boards within local councils to increase accountability
• providing support for all trusts to become foundation trusts and establishing independent regulation
• creating Public Health England to drive improvements in public health
• streamlining arm's-length bodies in a bid to reduce bureaucracy.

The government claimed the plans would improve the NHS in a number of key ways, including by providing “real democratic legitimacy, with local councils and clinicians coming together to shape local services”.

The measures are also expected to save the NHS more than £5bn by 2014/15 and then £1.7bn every year after that. The savings are largely expected to be achieved by abolishing strategic health authorities and primary care trusts, and reducing management staff by an estimated 24,500 posts.

Health Secretary Andrew Lansley said: "Modernising the NHS is a necessity, not an option – in order to meet rising need in the future, we need to make changes. We need to take steps to improve health outcomes, bringing them up to the standards of the best international healthcare systems, and to bring down the NHS money spent on bureaucracy. This legislation will deliver changes that will improve outcomes for patients and save the NHS £1.7 bn every year – money that will be reinvested into services for patients.

"This is the start of a cultural shift to a patient-centred NHS. The proposals set out today in the Bill will strengthen the NHS for the future and make the changes that are needed for vital modernisation to put more patients and NHS staff in control."

Sir David Nicholson, NHS Chief Executive, said: "Central to the Bill is mobilising the whole of the NHS to improve outcomes for patients and we should all welcome that. The reforms present the opportunity to develop a system designed to deliver that. The values and principles of the service remain unchanged, enshrined in the NHS Constitution and in the work of our staff every day.

"It is critical for the service to keep its focus and purpose of improving quality for patients and to make the reforms a foundation for improvement. This is a major challenge when we are already planning to make £15-£20bn efficiency savings but I am confident we will be able to do this, to establish a health and care system that achieves the best outcomes for patients."