Opinion: LGA conference In this feature health elderly care devolution Fast forward Suzanne Kuyser needed a fair turn of speed to cover the Local Government Association conference in Harrogate, with 250 more delegates than in previous years and the future of health and social care up for discussion A The NHS could learn from local government You are a shining example of better services at lower costs. We want to work with you SIMON STEVENS packed and interesting programme with parallel plenaries, breakout and fringe events, innovation seminars and mini-theatres ensured the Local Government Associations (LGAs) conference at Harrogate International Centre was buzzing from 30 June to 2 July, with exhibition stands popping up in all sorts of places. In the main auditorium, NHS Englands chief executive, Simon Stevens, followed a very condent Jeremy Hunt, Secretary of State for Health. After giving statistics on the cost of missed GP and hospital appointments and telling the audience there is no such thing as a free health service Hunt said only 16 per cent of elderly people in the UK live with family. He cited the recent case of Henry Summers, who was found alone in his Edinburgh at, three years after his death. Calling it a national shame that a million older people in the UK1 havent spoken to anyone for a month, Hunt would like us to take all our elderly folk into our homes, and save the NHS budget. I suspect what Hunt would really like is to have a law that forces us to do just that as in China and France2. He joked that of course we dont do things like that here, but did I hear a hint of regret in his laughter? One delegate suggested that taking the 20 per cent VAT off building a granny annexe might help move this forward, but Hunt didnt leap at this idea, preferring instead to announce that medicines costing more than 20 will have their price published on the packaging, so that less is thrown away unused. We can only hope they have done the research into how many older people will simply stop collecting their prescriptions when they see the price fearful of wasting the governments money. Its heartening that Hunt said he didnt want big structural change, calling instead for local initiatives, with central government neutral about the models. Relieved on the podium by Stevens, Hunt stayed to hear what he had to say. This was more like it sleeves rolled up, on the front foot, leaning on the podium. The NHS could learn from local government, Stevens said. You are a shining example of better services at lower costs. We want to work with you, he went on, to build in health planning, providing services such as GP surgeries in areas of new housing. Thats great, said a delegate: We heard you last time you said that, and we came to you but you said there was no money. Stevens, with his rolled-up sleeves, agreed that did seem a shame, but innovation and ideas were the way forward. It was a shame, because he really does seem to want to get down and dirty and save the NHS and the nation with a prevention agenda, with more work on health and social care integration and, of course, health-planning partnerships with local government. Although health and social welfare were the overarching themes of the conference, the issue that kept popping up was devolution. Just as Hunt wants to see local initiatives, rather than government-set models and concepts, so does Dr Jim McCormick, Scotland adviser for the Joseph Rowntree Foundation. Speaking in the Clash of the think tanks: the future for devolution plenary, McCormick said that, in Scotland, devolution feels like evolution. Richard Harries, deputy director Reform, appeared to agree with keeping things local, saying its absurd to suggest nationalisation solves things and sorts out the postcode lottery issues need to be sorted out on a case-by-case basis. This came up again in the Entrepreneurial Council, where speakers from Essex County Council, Huntingdonshire District Council, Hertsmere District Council and Suffolk County Council gave examples of how they made money or managed their services. All four had taken a different approach exactly as the government wants with: Hertsmere taking over ownership of Elstree Film Studios as an income boost; Huntingdonshire outsourcing its leisure facilities, resulting in it drawing down a surplus; Suffolk spending 65 per cent of its budget for services on suppliers; and Essex taking the approach that local government and business are not mutually exclusive. There was a strong message coming from the presenters that local models, based on local needs, were the way forward. While Suffolk County Council leader, Colin Noble, admitted its outsourcing wasnt always successful, he added: We dont always get it right when we deliver directly, emphasising that local authorities must become more lean and exible. Essex Legal Services, once a department of Essex County Council and now a commercial enterprise within the authority, is doing so well that it was in a position to sponsor the session. In the exhibition hall, it reported making plenty of contacts with good prospects. Essex Legal Services stand was opposite that of retirement housebuilder McCarthy &Stone, which also reported good footfall to its stand, as it worked up relationships with local authorities to build homes for older people, considering every kind of land deal, and local authority sites ranging from surplus car parks to ofce buildings. One of the afternoon plenaries focused on the politics of the future, with Naz Shah, MP for Bradford West, highlighting her constituencys particular issue: having the youngest city population in Europe. Devolution is what its about she told the delegates, with greater transparency from people in power to ensure everyone gets a fair share of the cake. David Hodgson, mayor of Bedford Borough Council, agreed, saying that devolution had to be made to work. From time to time, delegates raised the issue of what exactly devolution is is it different from decentralisation? Is the government saying devolution, while still pressing its policies and maintaining control? Perhaps this is why it kept popping up; a clear message, but with an obfuscated concept or construction in terms of UK politics and local government. Local authorities seem to relish opportunities to demonstrate businesslike skills and innovations, but the government is not clear about where it steps back or forward. I rounded off the day with a visit to the Woodland Trusts Whats green, saves you money and makes you feel better fringe meeting for a glass of wine and to collect the free tree sapling on offer. At this point, the air conditioning threw a wobbly and, instead of cool air, deposited a brief rainfall in the room appropriate for such a green theme. Order was soon restored and three very interesting presentations followed, from the Woodland Trust and local authorities. Jeremy Hunt, Secretary of State for Health We can only hope they have done the research into how many older people will simply stop collecting their prescriptions when they see the price fearful of wasting the governments money Peterboroughs Bourge Boulevard calmer and more attractive thanks to trees Call me cynical, however, but when you get a presentation by a director of health extolling the value of green spaces to stroll in and their impact on health the message lacks conviction when its clear that exercise of any kind, let alone strolling, has not been on their recent agenda. There were some splendid statistics on why local councils should plant more trees and create more green canopies including better emotional and physical health, plus environmental considerations. My respects go to Peterborough, which is currently busy planting some really big trees under its Trees and Woodland Strategy (outsourced) to make its grey concrete and tarmac Bourges Boulevard calmer, safer and more attractive. It looked great in the pictures Peterborough now added to the list of cities I must visit. References: 1 Statistics from Age UK. 2 In China, The Protection of the Rights and Interests of the Elderly bill says children must care for their parents spiritual needs, as well as their physical needs, as they grow older. Under French law, adult offspring are required to provide for ageing parents who do not have the means to look after themselves. Article 207 of the Civil Code states that children have a legal obligation to honour and respect their parents, as well as pay them an allowance and provide or fund a home for them. A judge may set the sum, with non-payers facing prison or a ne. Its a crime for descendants of people living alone to fail to keep themselves regularly informed of their state of health, and a crime not to intervene should they suddenly be taken ill. Credits Published You might also like Suzanne Kuyser is the former editor-in- Tuesday 25 August, 2015 Human right, spotlight interview, page 36 chief of TS Today and TS Review, and a consultant to CTSI. Images: Chris Sharp of TS Review, August 2015 issue. To share this page, click on in the toolbar