An unhealthy situation


Council staff may need to get that doctorate after all

My husband’s birthday is coming up soon.  I know it’s coming up, and that I will be expected to buy a nice present, perhaps cook a nice meal and maybe if he’s lucky arrange a bit of a party, but so far I haven’t.  Life’s been busy, other things have taken my time and attention and generally I’ve let it slide, no doubt to remember again a few days before and pick him up a ‘humorous’ card, a Chris Ryan novel and some random golf-related stuff.

In fact, I’m feeling very local government about it all.  You see, councils up and down the country are going through the same thing.  In 2013, the responsibilities previously undertaken by the PCT around public health will transfer lock, stock and anti-smoking barrel to their council counterparts.

2013 is just 15 months away.  If you were wondering, that’s 66 Mondays away from the day this post goes live.

But are we in the council ready?  Have we got long term plans and strategies in place to handle these changes, with work currently underway to prepare the ground for an influx of new officers and workstreams, working to understand how we can avoid simply tagging them on to other areas but really make them part of an integrated service and weaving them into the service delivery plans of their new colleagues?

Well, not exactly.  Having worked with a few PCTs recently, in this bloggers’ admittedly limited experience they’re not thinking that far ahead.  In fact, many seem to be actively ignoring it, appearing to know that change is coming but feeling that they have little control over what will happen, instead relying on the fact that it appears to be inevitable to trust that things will just fall into place.

On a positive note, some public health changes are beginning to evolve.  For example, Local Involvement Networks (LINKs) will soon become ‘Healthwatch’ groups, taking all of the old responsibilities of the LINk and adding on a few more for good measure to complete the public engagement bingo card (what do you mean, you don’t know what LINks do?).  Strategically speaking, health and wellbeing boards are also coming into place to oversee publicly funding health and care and better coordinate ever-dwindling resources.  However, it simply doesn’t feel like there is enough momentum to nudge two inertia-filled organisations together.

Much as I like the new Bill in many respects, it doesn’t help that the push for localism is encouragin each council to do things differently.  Whilst some are planning on sitting their public health service responsibilities in the same places as their social care work, others are planning on sitting them entirely separately.  As with so many things there will be little consistency, with each local authority choosing the route it sees as the most appropriate for its own particular circumstances.  This might work to an extent, but as we see more and more health service delivered over the borders of one, two, three or even more local authorities this could create a spaghetti-style system of hierarchies and reporting structures.

Besides those of us with a vested interest in either sector, most members of the public know nothing about these changes.  They will still see the council’s role as collecting the bins and sweeping the streets, whilst health care of any kind sits with the NHS.  Perhaps this doesn’t matter, as long as the service is delivered effectively it shouldn’t matter whether it’s a council officer or a NHS officer delivering it.  However, I can’t see it working that smoothly in the short to medium term.  This blogger fears that increasingly over the course of those next 66 Mondays staff on both sides with any responsibility for public health will spend more and more time considering the structural implications of this transfer of responsibilities, then months or perhaps years normalising and getting to grips with the ‘new’ system.  What odds that as they are approaching effective working standards, another restructure is planned?

It’s all just a bit too rushed, and a bit too confusing.  I don’t mind council officers doing health and safety checks, as long as they don’t forget the safety bit.

Welovelocalgovernment is a blog written by UK local government officers. If you have a piece you’d like to submit or any comments you’d like to make please drop us a line at:welovelocalgovernment@gmail.com

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