It was good to see the Right Honourable Patricia Hewitt's review into integrated health systems published recently. It was full of strong messages on the importance of prevention and encouragement for more joined-up system working.

It comes about a year on from the final report of the stocktake completed by Dr Claire Fuller which set out a clear plan for building integrated teams, which Dr Fuller regards as being ‘most powerful'  in neighbourhoods of 30,000 to 50,000.

And like many other colleagues across the local government sector, I'm doing my best alongside NHS partners to make some of this happen in my own place, Milton Keynes.

But this isn't easy work, and although we've had plan after plan, report after report full of clear and consistent messages about what needs to happen, building a properly integrated system is painfully slow.

Indeed in Milton Keynes the challenge now pre-dates an entire city. Back in 1969 an article appeared in the Architects' Journal all about the new city that was to be Milton Keynes. 53 years later and most of what was proposed has been delivered. A city designed to be home for a quarter of a million people now has 288,000 residents. The promised mix of schools, community facilities, leisure and industry all came together.

But the bold vision for what was described as a ‘pioneering health service' is still a long way off. Alongside drawings of new grid road systems, the article points to a ‘National Health Service due for development in several important respects. The most significant will be bringing together the family doctor, the local authority services and the hospital services into a single integrated system'.

A plan is proposed for a primary care and social services model for the city based around health centres and serving a population of ‘about 30,000'.

Half a century on and it's startling how similar this plan is to the one we are trying to realise today.

Let's hope the Patricia Hewitt review will enable us to make a breakthrough. It's certainly good to have some unambiguous recommendations about the need for less central control, much more financial freedom and a recognition of the important role of local government.

But the fact remains, when it's easier to build a new city than an integrated health and care system, you know this isn't a challenge that anyone should underestimate.

Michael Bracey is chief executive of Milton Keynes City Council

@MichaelRBracey