• Birmingham City Council chief likened situation between health services and social care to David and Goliath
  • CQC chief inspector warned of new silos being created if NHS took control
  • Another chief executive criticised the culture of “the centre and the local”

Birmingham City Council’s chief executive has questioned whether social care should be taken over by the NHS, stating it was unlikely to “win” financially while it remained part of local government.

Speaking in a fringe session at the Society of Local Authority Chief Executives and Senior Managers annual summit in Brighton last week, Dawn Baxendale suggested she had experienced first hand shortcomings in the integration of services through failure to join up the care of her mother, who recently died.

“I’m just coming to the conclusion we have a David and Goliath situation between health services and social care,” said Ms Baxendale. “I don’t think David is going to win in this situation.

“Because of where the NHS sits in the national psyche, should it be one system? Should we be running social care at all?”

She called for a debate about the sector’s status because “there is not enough money” in the system, and urged a “genuine understanding” among national decision makers about social care’s plight.

This viewpoint was challenged by Andrea Sutcliffe, the Care Quality Commission’s chief inspector of social care, who pointed out new silos could emerge, hindering the integration of services.

“Even if social care came into health – and I’m not arguing that it should…there would still be a boundary with housing,” Ms Sutcliffe said.

She paid tribute to councils and their chief executives for doing a “cracking job” by “maintaining or in some places increasing” the budget available to social care, despite local government experiencing reduced funding.

Ms Sutcliffe said councils had a “local leadership role with the democratic mandate that you have but the health service doesn’t”. This meant they could “make a difference” on service integration.

Robin Tuddenham, chief executive of Calderdale Metropolitan Borough Council and the spokesman on community wellbeing for the Society of Local Authority Chief Executives and Senior Managers, said local government was being “too nice as a sector” and urged it to “call out” NHS failure to recognise the vital role of councils.

He was critical of the fact he had not personally been sent a letter from the Department of Health and Social Care informing him of his area’s share of the £240m of extra resources for social care announced by health and social care secretary Matt Hancock earlier this month.

“That letter came to the leader and foundation trust. It was forwarded to me – they said ‘we thought you should be aware of this’. This is the culture we are working with – the centre and the local.”

Helen Bailey, interim chief executive of North Somerset Council, was critical of the fact her council would be required to make “monthly returns” about social care performance in return for the money, which were “stressful”.

And she was critical of the general level of complexity of working with the health service: “Working in a very small unitary, my life is full of meetings attended by hundreds of health people. The resources and bureaucracy that exists in the health service is making that work harder and harder.”