In an interview with Public Finance Norman Lamb says that he has his sights on 2018, as the date by which all health and care spending will be pooled in England. He said:
I want the approach to evolve rather than having anything imposed. The only imposition is to say that we have got to get budgets pooled locally completely, and I’ve talked to a lot of people about this and I think we’ve come up with a neat solution to achieve the pooled budget without a national reorganisation, which nobody wants.
The Better Care Fund seems to me to be the sensible way of achieving that objective, to progressively increase the extent of the pooling, and as you do that I think you remove the perverse consequences of the gaming across the boundary between the two.
The Better Care Fund is planned to start next year with initial funding of £3.8 billion, although Norman said that he expected the amount of funding pooled to be ‘significantly bigger’ than that figure. In a footnote to the article, we learn that since the interview he had been proved correct; 146 of the 151 Better Care Fund plans have been approved with £5.3bn of funding pooled from NHS and local government budgets.
He expects the mechanisms to vary across the 151 Better Care Fund areas.
You say to local areas, “this is the objective, it’s got to be pooled by this date, you set about working out your way of doing it”.
I think different models will emerge, and I see no difficulty with that at all, I favour a more permissive NHS where different areas do things differently.
Some areas might chose to base it on clinical commissioning groups with local authority representation on that board, some areas may chose to do it under the auspices of the local authority and the health and wellbeing board.
* Mary Reid is a contributing editor on Lib Dem Voice.