The report, ‘Creating NHS Local: a new relationship between PCTs and local government’, recommends bringing local health planning, funding and commissioning decisions under the control of local councils in England.
The provision and management of actual health services would continue to be the responsibility of the NHS and other providers.
The authors argue that councils are better at managing tight budgets, involving local people in setting priorities and communicating decisions to local people.
The report concludes: ‘We argue that local government needs the NHS to be a successful place-shaper, and that the NHS needs local government for local legitimacy and accountability.
‘Whether we bring NHS commissioning to local legitimacy (a local-authority-led approach) or bring local legitimacy to commissioning (democratising NHS structures), a new relationship between local government and PCTs is crucial.’
The report’s co-author Dr Jon Glasby, head of health and social care at the centre, said: ‘The government is actively seeking ways to separate the planning and provision of health services.
‘Councils are already an established part of every local community, playing a key role in schools and social care, so taking on the planning and funding of health services is a logical step.
‘It will also give people a greater stake in local services — being able to influence health services would be very likely to increase turnout in local elections.
‘Bringing health commissioning under the same body as public transport, recreation and planning would also help push forward the government’s public health agenda.’
Although the idea could not work with existing plans for practice-based commissioning (PBC), health secretary Patricia Hewitt has voiced admiration for plans that see more joint local commissioning between the NHS and local councils. (GP, 14 July)
GPC negotiator Dr Richard Vautrey said that ‘any move away from clinician involvement was a retrograde step’, but welcomed more involvement from local councils.
‘There is a role for local authorities in commissioning as there is for all stakeholder groups and they can advise what is best in some areas,’ he said.
‘You do need these mechanisms to consult more widely with the community but ultimately the decisions should be made by the GP commissioning groups.’
