A proposed constitutional clause excluding councillors and MPs from integrated care boards will allow the NHS to seize powers from local authorities, councillors have argued
It does need some grown-ups in the room who understand about local service delivery, and what residents really want. From the way… they see the boards progressing, the acutes will absolutely gain power and money. That’s what it's all about." Graeme Miller, leader of Sunderland City Council
Councillors have expressed concern that the new integrated care systems (ICSs) will enable the NHS to seize power from local authorities, with one council leader saying he could see a “car crash coming”.
ICSs, due to come into force in July, will consist of integrated care boards (ICBs), which will bring together local NHS organisations, and integrated care partnerships (ICPs), an alliance of local representatives convened by both councils and the NHS.
At a meeting of the city regions board of the Local Government Association (LGA) last week, some councillors said they could see “choppy waters” ahead when the new system comes into place.
NHS England’s model constitution for ICBs “explicitly excludes councillors and MPs,” according to a report to the LGA. This has provoked fears that the NHS is planning to reclaim public health powers and seize more funding for acute services. Although the model of excluding councillors and MPs is not stipulated in the Health and Care Bill that will bring ICSs into law, councillors believe that many ICBs will adopt it. The report says that the LGA has made “strong representations” to NHS England to remove the clause from the model constitution, but that these were unsuccessful.
Danny Thorpe, the Labour leader of Greenwich Borough Council, and London Councils’ executive member for health and care, told the meeting: “Our main issue with the setup of the two boards is you can’t have a load of health people sitting in one room with all of the money, and local government people sat next door talking about how wonderful it is to work together.”
Graeme Miller, the Labour leader of Sunderland City Council, was more forthright, accusing the NHS of an “attempt at political castration” in its efforts to exclude politicians from ICBs, which would mean “scrutiny is effectively ignored at a local level”.
He described it as a “terrible move,” adding: “I’ve always found that the NHS, when it speaks to itself, just speaks rubbish”.
Miller went on: “It does need some grown-ups in the room who understand about local service delivery, and what residents really want. From the way… they see the boards progressing, the acutes will absolutely gain power and money. That’s what it’s all about.”
He was “very nervous,” he added, about the size of the North East and North Cumbria ICS: “Quite how having an ICS that runs from the Scottish border down to the south of Yorkshire is going to deliver place-based service delivery to residents in Castle ward in Sunderland… Christ knows.”
Describing the model as a “car crash coming”, he said that the NHS would “force it through.” He added: “What we’ve got to try and do is get them to see sense, and hopefully listen to us and understand that the local authority structure is a very good partner for them. But they’ve got to then treat us like grownups. We’re not there as a tick box exercise.”