Local authority social care risks being politicised, warns think-tank

By The Press Association17th November 2014News EnglandBetter Care Fund, Care Standards, Local Authorities, News England, Older People

The decision to give local authorities extra public health responsibilities risks creating a “postcode lottery” and has increased the danger of political interference, a think-tank has warned.

The International Longevity Centre – UK (ILC-UK) – said localism had the potential to transform public health, but warned against councils setting short-term targets instead of focusing on longer term measures.

The report said politicians in town halls could invest in “quick wins” to boost their chances at the ballot box rather than on schemes providing no immediate electoral benefit.

Jonathan Scrutton, senior policy and research officer at ILC-UK, said: “There is a huge invest-to-save argument. Early investment in preventing ill health in old age can reduce long-term care costs.

“Localism has the potential to transform public health and deliver better and more targeted services. But if local authorities are to maximise the long-term benefit of investing in preventative health, they must not get drawn into simply achieving short-term targets.”

Under sweeping changes in the Health and Social Care Act in 2012, since April 2013 local authorities have been responsible for public health services in their area.

The ILC-UK report said: “The localism enshrined into the Health and Social Care Act creates an opportunity to tackle the challenges presented by our rapidly ageing population at a grassroots level.

“Some localities are embracing this opportunity by taking a life course approach to health, commissioning services that both encourage healthy ageing and improve the health of the current old.

“But local authorities have gained these additional powers at a time when they are struggling under the weight of funding cuts, face significant public service responsibilities, and when they need to step up to the challenge of responding to an ageing population.”

The report said the change “has the benefits that local health priorities can be addressed by targeted initiatives, and innovative strategies can be developed that encourage more integrated working between departments”.

But it warned that “it also has the potential to worsen the effects of the ‘postcode lottery’, where the quality and availability of NHS services older people can expect are defined by where they live”.

The report added: “Another possible challenge arises when one considers that elected officials, being elected for a fixed term, may have a tendency to favour short-term solutions when in fact many of our public health problems require longer term investment.

“Faced with an upcoming election, politicians may invest in ‘quick wins’ to aid their re-election, rather than prioritising those problems, such as improving nutrition across the life course, that bring about benefits in the long term.”

The think-tank recommended that local health strategies should prioritise long-term health initiatives over short-term target hitting.

It said health and wellbeing boards should take advantage of councils’ links with their communities to maximise the potential of public health impact and to ensure that the voices of older residents are heard.

The NHS Commissioning Board should work to support consistency of quality across the country and help reduce differences in healthy life expectancies.

The ILC-UK added that Whitehall should ensure that local authorities’ public health budgets “continue to meet the needs of local citizens” after the current two-year ring-fenced period expires.

A Department of Health spokesman said: “People’s health varies widely across the country, which is why we have scrapped a one-size-fits-all approach and are empowering communities to tackle their own specific problems, backed by billions of pounds in ring-fenced funding.

“But councils are held to account and must still prove their strategies are working.”