A key architect of the health and wellbeing board model has expressed concern at possible Labour proposals to make the boards the NHS’s main commissioning bodies.
John Wilderspin, who served as national transition director at the Department of Health, was asked about shadow health secretary Andy Burnham’s mooted plan to merge the health and social care systems, which would see the boards become the NHS’s main decision making bodies.
Speaking at the NHS Confederation conference in Liverpool, Mr Wilderspin – who has now moved on to become managing director at the Central Southern Commissioning Support Unit – said: “There’s no bigger fan of health and wellbeing boards than me but I thought ‘that’s pushing the boat out!’
“Pooling budgets is a good thing and if you have a national health service and local government, it could be a creative tension, but if you made [the boards] responsible for everything it could lead to some really difficult political issues.”
Later, speaking to HSJ, Mr Wilderspin said that while HWBs were “visible manifestations” of the vital joint work between health and local government, it was “too much of a massive leap” for them to be the forum for funding decisions.
“There’s so much complexity around the way local government works, and is funded and elected, compared to the way the NHS is funded and decisions are made nationally, it would be an incredible complexity to bring that together in one body,” he said.
In the session, Mr Wilderspin also accused some HWBs of not “stepping up to the plate” by asserting themselves locally.
“That’s something I find appalling,” he said, “If they don’t work we are screwed.”
Joyce Redfearn, director of health and wellbeing system improvement at the Local Government Association, declined to comment to HSJ on the Labour proposals. However, she added: “What we need to be talking about is making this [current] model work to the best of our abilities at pace and at scale.”
Mr Burnham has set up an independent commission into the idea, which will be led by former Department of Health clinical lead for efficiency and productivity Sir John Oldham.
The session also saw HWB member and Doncaster Council director of public health Tony Baxter express concern that local government elections could lead to a major turnover of HWB members affecting local relationships. His HWB has seen six new representatives recently added.
“It will be hard to maintain relationships build up over two years,” Dr Baxter said.