How has local government and localism come out of the Field Future Forum report? Pretty well: the forum recognises the potential key role of health andwellbeing boards and, indeed, wants to see this strengthened; they wantthe new consortia to be coterminous with council areas (though clearly theones already set up are not – will they have to reorganise again?); Monitor will be responsible for promoting cooperation and integration as well ascompetition; the new bodies will be subject to normal public sector opennessand governance standards (it is incredible that this was not the case in theBill); there will be a stronger patients voice.
Of course, there are still questions: it is easy to talk about cooperation, less easy to achieve – and integration between which parts of health andsocial care? There will still be tensions between the HWBs and the newconsortia, which will continue to be GP led. Competition doesn’t fit happilywith cooperation. We still have to see an amended Bill.
It is clear, though, that those parts of the Bill that were largely welcomed,such as the transfer of public health responsibilities, the emphasis on tacklinghealth inequalities and the new role of councils in bringing together carelocally, remain intact and probably will emerge stronger. Local governmenthas all to play for.
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