At last week's Local Government Association conference there were calls to "replace the NHS with the LHS" - Local Health Service.
Chairman of the LGA Social Care Board, Cllr David Rogers, said:-
"This is a serious debate designed to spark new ideas about how or if the National Health Service needs to be brought closer to the people they serve. People say that health and social care are two sides of the same coin, the question posed is whether health and social care should become one side of the same coin?"
An LGA commissioned report - Improving Services, Improving Governance – calls for the boundaries between the NHS and local government to be torn down and powers devolved to community level to improve services.
Professor Gerald Wistow, visiting professor of social policy at the London School of Economics and author of the report:
"Decision making and spending by local government and the NHS must be brought closer together. The support that now exists for preventative, community-based solutions is not enough on its own. There has to be change to the way services
are controlled as well as a policy context."
I reckon this to a good move, particularly for matters of public health. But with local discretion comes tough decisions about where to allocate money. This doesn't just mean tough decisions by white-coated professionals and health bureaucrats, but working with local people to make some of the decisions so that everyone can own the trade-offs this will necessarily entail.
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