Councils should take Responsibility for Commissioning Local Health Services

Posted on Friday 22nd September 2006

Planning and commissioning local health services, needs to be taken out of the hands of primary care trusts and should be entrusted to local councils instead, according to a new report by the University of Birmingham’s, Health Services Management Centre.

The paper: “Creating NHS Local: a new relationship between PCTs and local government” argues that local councils should have a more powerful role in determining health spending priorities thus bringing a greater degree of local democracy to NHS decision making. Jon Glasby and Judith Smith urge a radical rethink of the current health commissioning system, suggesting there is a need to give people a greater say in the funding and planning of local health services. The report argues that the local NHS needs to find new ways of engaging local people in the development of new services, and in explaining tough decisions when facing budgetary constraints. Professor Judith Smith explains: “The NHS has always been a very centrally-run service, and most local people do not understand the role and purpose of their local primary care trust. The NHS needs to find a new approach to making and explaining these difficult decisions about services to local people. If the furore over changes to Kidderminster Hospital showed anything, it is that health service planning and commissioning currently struggles to relate to local people in a meaningful way.” The report recommends bringing local health planning, funding and commissioning decisions under the control of local councils, with the provision and management of actual health services continuing to be the responsibility of the NHS and other providers. The authors argue that councils are better at managing tight budgets, involving local people in setting priorities, and communicating decisions to local people. The report’s co-author Dr Jon Glasby comments: “The government is actively seeking ways to separate the planning and provision of health services. Councils are already an established part of every local community, playing a key role in schools and social care, so taking on the planning and funding of health services is a logical step. It will also give people a greater stake in local services - being able to influence local health services would be very likely to increase turnout in local elections. Bringing health commissioning under the same body as public transport, recreation and planning would also help push forward the government’s public health agenda, something that is crucial to tackling issues such as rising levels of obesity. Commentators are agreed that NHS commissioning has not been successful in recent years. Only a radical rethink of the way services are planned and commissioned will make a significant difference, and this entails removing that responsibility from the NHS.” ENDS For more information please contact Ben Hill, Press Officer at the University of Birmingham, telephone 0121 414 5134, mobile 07789 921163, email b.r.hill@bham.ac.uk The full paper: “Creating NHS Local: a new relationship between PCTs and local government”- can be viewed on the HSMC website. http://www.hsmc.bham.ac.uk/ NOTES TO EDITORS Dr Jon Glasby Jon Glasby is head of health and social care and a Reader at the Health Services Management Centre, University of Birmingham. A qualified social worker, he is also a board member of the Social Care Institute for Excellence. Judith Smith Judith Smith is Senior Lecturer and Director of Research, Health Services Management Centre, University of Birmingham. Judith has been involved in health services research for twelve years, before which she worked as a senior manager in the NHS. Her research interests are concerned with primary care, commissioning, organisational development, and international health policy. COMMISSIONING ‘Commissioning’ is the strategic planning and resource allocation function of the NHS, mostly done by Primary Care Trusts (PCTs). It involves buying in services from a range of health service providers (including GPs, dentists, and community pharmacists, NHS and private hospitals, and voluntary sector organisations) to meet the health needs of local people, and monitoring how well they are being delivered.