Lamb backs legal requirement to pool budgets

The Liberal Democrat minister also wants local health and council commissioners to pool their entire budgets, he told the NHS Confederation conference in Liverpool.

Mr Lamb said he was pressing for these measures to be written into his party’s manifesto, as it gears up for the general election next year.

“Ultimately I think the whole health and care budget should be pooled,” he said.

“It doesn’t actually surely make sense to have two separate budgets in a local area, two organisations doing the commissioning.

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“So I would like my party’s manifesto to argue for a legal obligation to pool whole resource for health and care in a local area.

“We should end the disputes about who pays for care.

“The whole spectrum of care, from the social end to the acute end, is surely interrelated.”

Mr Lamb said he would want each local areas to work out “exactly how they want to achieve” this wholesale integration.

His proposed expansion of the better care fund would not be a “top down reorganisation” but about “local areas deciding how to maximise the potential of a pooled budget”.

Mr Lamb told HSJ it was “blindingly obvious… that we need to pool the whole resource but then just leave the local areas to determine… how it’s done”.

“You could have some local government representation on the clinical commissioning group, you could do it through the health and wellbeing board,” he suggested.

“I don’t prescribe how it’s done, but I just think the case for pooling the budget for health and care budget is overwhelming.”

He added that his ideas for future of the fund were a “view that I have, which is not yet party policy”, but that his proposals were “going through the manifesto process”.

Mr Lamb’s proposal to make pooling a legal requirement received a lukewarm reception from local healthcare commissioner groups.

Steve Kell, leadership group co-chair of NHS Clinical Commissioners, said he “would be concerned about the top-down legal requirement” to pool budgets.

“The better care fund is a move in the right direction, but what we need are local solutions,” he added.  

“[CCGs] looking at what works best with elected members I think is the way forward rather than a top-down edict.”

Carolyn Downs, chief executive of the Local Government Association said the body did not yet have a view on the legal requirement to pool budgets, but agreed with Mr Lamb’s ambition for a wholesale pooling of budgets.

“We very much think that local authorities and the NHS should be encouraged to combine the whole of our budgets,” she said.

“Having said that, integration, even within an organisation, is hard.

“Integration between different bodies with different cultures is even harder.” 

Mr Lamb also told the conference that the government was “very close” to issuing guidance that made information sharing a legal duty. “It’s not an optional extra”, he said.

“To provide good care, there is a duty to share. You will hear further on the subject very soon.”