Battle lines have been drawn between local government and the NHS in the run-up to the Treasury's next public spending round.

The Local Government Association this week called for NHS cash to be diverted to social care in the comprehensive spending review.

It is urging ministers to direct 0.5 per cent of NHS funds into preventive services for the elderly.

But the NHS Confederation said the call was 'over-simplistic' and that local government was already well placed to influence health.

LGA chair Sir Simon Milton wrote to all council leaders warning cuts in services for the elderly and tighter criteria for free and subsidised care were inevitable if funding did not rise. He said: 'There is a compelling argument for ministers to invest in preventative [council] services for older people in their homes. This would save the NHS money, and provide better value for the taxpayer.'

But NHS Confederation chair Bryan Stoten said it was 'over-simplistic' to say that stripping cash from the NHS was a solution.

He pointed out that local government had more control over spending and could make a huge difference to health.

'Prevention starts with early years education housing and a whole raft of things local government is responsible for,' he said. 'Local government has the ability to flex its budgets, whereas health has single pots for community, primary, secondary care.'

He added: 'We are facing a major demographic change and recognise we're going to have to change the services we provide.

'I am sure Sir Simon is trying to be helpful. [But] I think on this one it would have been sensible to have had a conversation with us rather than shaving bits off other services to pay for your own,' he said.

The debate will fuel fears that there is still a gulf between the NHS and social care despite government efforts to bridge the gap.

NHS chief executive David Nicholson told HSJ this month that the Department of Health's submission to the CSR looked at health and social care together (to read the full story, click here). 'A poor settlement for social care and a good one for the NHS does not help the overall position,' he said.

King's Fund chief economist John Appleby said there was evidence to suggest the Treasury was increasingly looking at health and social care as a package.

'I get the impression from Treasury people that they're aware of the issues to do with social care,' he told HSJ. 'There is even a feeling that social care has lost out a bit in the largesse to the NHS.'