The
Manchester experiment is not the way to integration
The
divide between the NHS and social care divide is increasingly blamed for a
crisis in A&E services, so-called “bed-blocking” and much suffering, waste
and inefficiency. So it is hardly surprising that the Manchester experiment to transfer billions in
NHS funding to the council has been met with widespread interest and support.
This will mean that local authorities have control over health and social care
budgets.
But what
if instead of upping the game of the NHS – Britain’s most loved public service
– this brave new idea merely drags it down it to the level of social care, the
most devalued and misunderstood welfare service? This is a possibility that
demands more rigorous attention.
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care network
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We need
to look at the problems Manchester
is trying to solve. First, by shifting funding from the NHS to the local
authority, the aim is to meet the growing need for long-term support resulting
from changing demographics. Older people and long-term conditions now make the
major demands on our healthcare system. Second, by putting the local authority
in charge, the goal is to shift from a hospital-based medical model, to a
social approach that keeps people in the community and maintains well-being.
Most of all, the aim is to put an end to the traditional health and social care
divides that have been costly, wasteful and ineffective.
A reprint:
Lava spurts out of the site of a volcanic eruption at the Eyjafjallajökull volcano near the Eyjafjalla glacier in Iceland on March 27, 2010. (HALLDOR KOLBEINS/AFP/Getty Images)
We were stuck on the island of Mallorca for two full days during our recent holiday because of 'volcanic ash'. Iceland was of course in the news before the recent volcanic eruption.
The Met Office has been blamed for triggering the “unnecessary” six-day closure of British airspace which has cost airlines, passengers and the economy more than £1.5 billion. Telegraph
Have we really learnt anything?
GPs to sit on local authorities as councils take on key commmissioning role
23 Jul 10
GPs will be forced to work closely alongside local authorities when the new era of GP-led commissioning begins to take place, the Government has revealed.
The details of the plans for GPs to take on commissioning responsibility, published this week in a White Paper consultation document, reveal GPs will be required to sit on new local council ‘health and wellbeing' boards.
GP consortiums will work in partnership with local authorities to jointly plan and commission health and adult social care, public health and integrated care, with local authorities acting as the lead commissioner for certain services, such as older people’s care.
And local authorities will be given the power to block GP commissioning strategies if they do not agree with a consortium's plans, and refer disagreements to the Independent Reconfiguration Panel.
GPs will also have to cooperate with local councils and other agencies in relation to criminal justice.
Local authorities are set to play a much more prominent role in commissioning, the document states, and will be given ‘a new enhanced role’ in promoting public involvement in decisions about service priorities and changes to local services, and in responding to any public concerns about inadequate involvement.
‘Local government will have an enhanced responsibility for promoting partnership working and integrated delivery of public services across the NHS, social care, public health and other services. One way in which this could occur is through health and wellbeing boards which would include representatives from GP consortia.’
The key points from this release are:
A total of £929.2 million was invested by English local authorities in Icelandic banks as at 31 December 2008. This amount was invested by 125 local authorities out of a total of 482 authorities.
39% of the investments were with Landsbanki islands hf, 29% were with Heritable Bank Ltd, 20% with Glitnir Banki hf and 12% with Kaupthing Singer & Friedlander Ltd.
96% of the investments were internally managed while the remaining 4% were externally managed. There were no externally managed funds invested with Heritable Bank Ltd
Within the total, £24.6 million was invested on behalf of other local authorities. All these investments were made on behalf of fire or police authorities.
Should we exclude 125 Local Authorities?
13 April 2010
The damning verdict of Iceland's so-called "truth commission" into its banking system is set to add to calls for a similar inquiry in Britain.
Even though the state injected an estimated £1.2 trillion into Britain's financial system, including the nationalisation of two banks (Bradford & Bingley and Northern Rock) and part-nationalisation of two others (Royal Bank of Scotland and Lloyds Banking Group), there has been nothing like the Icelandic report in the UK. Analysing what went wrong, and the roles played by the Government, the Financial Services Authority and the Bank of England, has largely been left to the institutions themselves or the Commons' Treasury Select Committee.
And while the latter has conducted lengthy hearings, it remains the case that British select committees do not have the clout of, say, US congressional committees. Despite the select committee's best intentions, membership is still in the gift of party whips and it cannot be considered truly independent in the way the Icelandic Commission or its US equivalents have proved themselves to be.
President Obama has, for example, created the Financial Crisis Inquiry Commission, charged with grilling hundreds of people from the investment community, large banks, the US mortgage industry, government agencies and academia. Then there was the devastating 2,200-page report into the collapse of the 158-year-old Lehman Brothers by US legal examiner Anton Valukas, which pulled no punches and embarrassed prestigious names on both sides of the Atlantic. There appears to be a desire to learn lessons across the Atlantic – and in the middle of the pond – that is lacking here.
Related:
Telegraph: Axe falls on NHS services
Related:
Telegraph: Axe falls on NHS services
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