Latest Public Sector News


Betts: GM devo deal a halfway house to aligning health and social care

Establishing clear lines of accountability to deliver health and social care integration is going to be one of the major challenges facing the sector going forward, the chair of the Communities and Local Government (CLG) Committee has told PSE – adding that GM devolution is a “halfway house towards it, but still leaves some of the questions unanswered”.

Following last week’s Spring Budget, where the chancellor announced an extra £2bn for social care and promised a green paper, Clive Betts MP said: “Obviously, we are pleased that the chancellor has recognised that the problems of social care need more money, but are disappointed that he hadn’t gone as far as the committee asked.”

He added that his committee also requested a National Audit Office review to establish a figure that everyone could agree on with regards to the social care funding gap, but “ the government didn’t even mention that”.

“To pluck another £1bn over two years and say that is enough misses the point,” argued Betts. “The chancellor can’t be certain it is enough; he has no credible evidence to back it. And we could be back here in a year’s time having the same argument.”

Discussing the GM health devo model, whose ambitions could be ‘gnawed away’ due to social care cuts, he told us: “Pooling budgets is sometimes called joint commissioning, and there are different ways of doing it.

“The one difficulty with all these things is that they tend to work until they go wrong, and then everybody blames everyone else. You really have to have clear lines of accountability, but currently health and social care have very different accountability systems. Social care is accountable to, ultimately, elected councillors on the local authority. Health is accountable to the secretary of state.

“I don’t think government yet has a clear view of how that works. The Manchester system is a halfway house towards it, but still leaves some of the questions unanswered.

“These are very different systems, and that is going to be a challenge for the future.”

While admitting that health and social care integration can go some way to reducing the stress on both systems, the committee chair noted that as NHS England’s chief executive, Simon Stevens, told them, “integrating health and social care will bring benefits, but it won’t solve the problem of social care funding in the long term”.

The Sheffield South East MP added: “If anyone thinks all we have to do is get social care and health to integrate and then everything will be fine, then they are missing the point. We are still going to have a continuing need for extra funding for social care, simply because of demographics.”

A CIPFA survey recently revealed that households in England face the highest council tax rise in a decade, on average a rise of 4%, as local authorities attempt to tackle the social care shortfall.

Betts, whose committee is carrying out an inquiry into adult social care, said: “There are massive challenges ahead. No one has given us evidence that it could all be funded by the public sector.

“Most people want to see there is a strong local element in it, with local accountability. How you put that together, recognising the significant changes about localisation of business rates, which are coming as well, are issues we need to reflect on.

“We have, however, had clear evidence from the local government sector saying that the demand for social care is going to go up faster than business rates will.

“Those are problems in the system that are going to need long-term resolution. We have had lots of problems presented to us, but not a comprehensive solution. That is what the green paper should be looking at.”

Top image: John Stilwell

Have you got a story to tell? Would you like to become a PSE columnist? If so, click here 


There are no comments. Why not be the first?

Add your comment



public sector executive tv

more videos >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the open more > more last word articles >

public sector focus

View all News


Building a more diverse society

05/03/2018Building a more diverse society

Karl Wilding, policy director at the National Council for Voluntary Organis... more >
Developing our future leaders

05/03/2018Developing our future leaders

Kerry Bishop, apprenticeship and qualification development manager at the L... more >


Keeping London safe

05/03/2018Keeping London safe

Theo Blackwell, London’s first-ever chief digital officer (CDO), spea... more >

the raven's daily blog

Apprenticeship levy – five myths busted

05/03/2018Apprenticeship levy – five myths busted

On the first day of National Apprenticeship Week 2018 (NAW 2018), the director of the National Apprenticeship Service, Sue Husband, challenges some of the key myths around the... more >
read more blog posts from 'the raven' >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this feeling of imminent change than the article James Palmer, mayor of Cambridgeshire and Peterborough, has penned for us on p28. In it, he highlights... read more >