The Local Government Association’s vision for public services argues for Area Boards to be accountable for healthcare and policing. The boards of primary care trusts would be abolished and the chair of the police authority would be a member of the Area Board. This change in accountability would lead to better decision making that took into account inter dependencies and was not constrained by ring fence budgets.

The proposals for this accountability move in the LGA document ‘Place-based budgets – the future governance of local public services’ rely heavily on evidence from the total place pilot reports.

Interdependence is a key feature of public services which is well recognised by the end user, but not always by the provider. The client groups of healthcare providers and the police will usually be the recipients of services from other providers. The Bournemouth and Poole total place pilot showed that a joint approach between health and social care in caring for the elderly can deliver a better result at a much lower cost.

Moving healthcare and policing to the Town hall would also produce better decisions about investing to reduce future costs. The Leicester and Leicestershire total place pilot found that £89.3m was spent on alcohol misuse, but only £4.9m on prevention.

The Communities and Local Government Reform Plan and the Health White Paper make no mention of governance changes that would allow an area based approach to be adopted. The reform plans of other departments have not been published yet, but they are unlikely to propose any governance changes. Read more about double vision on public services of the future