Social care is central to next reforms

Politicians agree that the NHS must work more closely with social care, says Edward Davies.

After fears of new policies and reorganisations voiced throughout the NHS Confederation conference for PCT managers in Birmingham last month, leading politicians of all parties were keen to allay such worries.

Health secretary Patricia Hewitt said that the government had to stop 'doing change to people' and start listening.

Conservative shadow health secretary Andrew Lansley said that if he became health secretary 'further upheaval is the last thing you need'. Liberal Democrat health shadow spokesman Professor Steve Webb opened his speech by saying there had been 'too much reform too fast'.

Social care

Despite these promises, the push to align health and social care was a constant theme at the conference and something that would mean more change.

The White Paper, 'Our Health Our Care, Our Say' mentioned social care more than 300 times and subtitled itself 'Health and social care working together in partnership'.

The RCGP has backed calls for GPs to work across housing and social care (GP, 16 June).

Ms Hewitt told the confederation conference that cooperation needed to develop at many levels: 'I think it's often easier to join up services at a local level, but undoubtedly there are common responsibilities of departments. Each department has its own complex challenges, but we need to remove barriers. Sure Start is a good example of how to do this.'

Sure Start is the government programme working predominantly with young children. It brings together education, childcare, social care, health and family support, crossing a number of government departments and funding streams, with the aim of giving children a better start.

It appears SureStart is now also a model for work in the NHS.

More joint working

Greater tie-up between departments is not just a Labour policy. The LibDem's Prof essor Webb hailed recent changes that have made two thirds of PCT boundaries coterminous with local authority boundaries, and hoped to see 'much closer working with social services'.

However, he wants to go even further than occasional joint working.

'We are not now going to attempt a complete merger between the two, but in the medium term it is something we should be getting close to,' he said.

He went on to ask delegates whether they thought it might be possible for every local council to have a designated 'health and social care councillor to build relationships with their health community'.

The White Paper recognises that services such as transport, housing, leisure and education must work closely.

Ms Hewitt has already had talks with culture media and sport minister Tessa Jowell over devising a sports strategy to help improve public health.

The Working in Partnership Programme (WiPP), a DoH advisory group, has described practice-based commissioning as the ideal conduit to achieve greater joint working across government (GP, 10 March).

But Hugh Taylor, the acting permanent secretary at the DoH, urged delegates to look outside the NHS.

'The local government White Paper is coming out in the autumn and will be very important to people working in health,' he said. 'We shouldn't get too hung up on existing structures.'

So whatever the DoH and politicians speaking on health promise, the changes may have some way to go. It is just that they may be driven from a local government perspective. Keep an eye on your local council's activities.

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