The health white paper unveiled this week significantly strengthens local democratic oversight of health services. Is local government up to the challenge?
Our care, our health, our say gives local government's overview and scrutiny of health services real teeth as a patients' champion, with the power to compel a primary care trust to review contentious decisions or the level of GP provision.
ministers plan to shift some resources away from acute services.
And the good news continues. The white paper makes clear the Department of Health sees local area agreements as an important mechanism for breaking down barriers between local government and the NHS, and there are indications of a willingness to honour the spirit of LAAs by giving councils and their partners more control over how they reach their targets.
The paper promises further integration of social care and NHS services, including budgets and workforce planning. Inspection will be rationalised and joint appointments will be more common.
This will help deliver a more seamless service, but as ministers flesh out the details they must resist the temptation to subsume care services in an NHS which, despite the rhetoric, will always be dominated by acute care.
The white paper represents the biggest move towards a locally accountable health service since the damage
inflicted by the 1974 reforms.
It is a major test for local government. Delivering effective health oversight, strengthening partnerships with the NHS and the voluntary sector, acting as patients' champion and exploiting every opportunity to provide seamless services must be accorded the highest priority.
Helping improve health care would be the best argument possible for localism. This opportunity must not be squandered.