Leading local authority and health service figures have taken part in a series of debates dubbed ‘local government fight club' to tackle three key contentious issues surrounding care and health provision.

Delegates discussed obstacles to progress – integration, the introduction of a national care service and achieving sustainability at an event held yesterday at the People's History Museum in Manchester and organised by the New Local Government Network (NLGN) think-tank and PA Consulting Group.

Tameside MBC chief executive Steve Pleasant argued for integration as a way to fixing a fragmented system and silo system.   ‘Integration means the money is invested in community services – accessible and holistic primary care.  Help where and when it is needed.  It is a no-brainer.'

But in response, Paul Simic, chief executive for the Lancashire Care Association said: ‘There is not a lot of evidence that there are wide savings to  be made from integration.

He said there seemed to be a lot of ‘over-claiming because we feel something must be done and our preference is for something hard and simple not soft and complex.'

‘The emphasis should be on service integration rather than on organisational integration,' Mr Simic said.

In the second debate, delegates discussed the concept of a national care service, handing responsibility of care away from councils and in the hands of central government.

Warwickshire CC chief executive, Jim Graham, who spoke in favour said: ‘Local government is as much a part of the problem as the NHS.'

He made the case for a two-tier arrangement whereby local government would remain as commissioner of the marketplace dealing with complex needs with 80% of simpler cases going to a market-led service.

Countering this view, Staffordshire CC's commissioner for care, Martin Samuels, said removing adult care from local authority control would make an already inter-connected system even more complex.

‘The NHS does not provide a particularly good model of provision of services with user control and user choice, which is essential to the shift in public attitudes needed,' said Mr Samuels.

In the final session on sustainability, delegates considered local government's long-term challenges of building social capacity as a means to drive savings and how better sharing and use of data could reduce duplication.

NLGN director, Simon Parker said: ‘By challenging some fundamental assumptions around health and social care, we can enable local government to consider the radical solutions that are required if we are to have a system that is sustainable and fit for purpose.'