Senior figures from three main parties back greater role for HWBs

Speaking at a King’s Fund event on integrated commissioning this week, Conservative MP Stephen Dorrell said the boards are “one of the innovations of the [Health Act 2012] that will stand the test of time”.

Mr Dorrell, a former health secretary who chaired the Commons health committee for much of this Parliament, was responding to a question by King’s Fund chief executive Chris Ham on who should be in charge of a single integrated budget for health and social care.

While they are currently “not the finished article”, Mr Dorrell said the boards “will evolve” to bring together health and social care, and “should bring together social housing”.

“It provides the opportunity for democratic local input into decision making about the shape of local health and care services,” he added.

Labour proposed in its 10 year plan for health and social care that HWBs would become “system leaders” for services for people with multiple long term conditions.

Labour peer Lord Hunt said there was “no doubt” HWBs were “the only way that you will get integrated commissioning”.

However, he stressed it was “not about giving [local authorities] free reign over a budget, and… if anything goes wrong in health, that’s someone else’s responsibility”.

“This is about… local authorities accepting responsibility for the workings of the whole system,” he added.

Liberal Democrat MP and former care minister Paul Burstow said the better care fund - the existing pooled budget for social care and community services controlled by HWBs - should be expanded to include acute budgets, primary care and the whole of adult social care.

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However, he said he was “agnostic” about whether budgets should be held by the boards or clinical commissioning groups. “It would depend on the capability and appetite [of organisations] to lead on those things,” he explained.

Lord Hunt, who chaired Heart of England Foundation Trust until last year, was critical of the lack of involvement by providers in better care fund plans, and claimed they had been pressured by regulators to sign them off.

“What was striking for me is we were never part of the discussion,” he said.

“Although… the trusts were required to sign off the plans, they actually don’t believe in them”.

Mr Burstow said, unlike Labour, the Liberal Democrats “don’t have a separate plan” for health. “We have the five year forward view. That is the plan,” he said.

“It’s the product of actually creating a more arm’s length, independent NHS through the Health and Social Care Act.

“As a consequence of that I think we have a plan that is capable of securing broad based, cross-party, cross-professional support, which now should be backed and made to happen.”