This article was first published in The MJ
The political shocks of 2016 suggest that there may be an appetite among voters for radical action to tackle social problems. Whether this can be translated into positive change in local government remains to be seen.
However, if councils are to stand any chance of meeting the future demands made on them, they are going to have to find ways of raising significant extra finance and will only be able to do this if they embrace radical change.
Our recent survey of senior county councillors at the County Council Network conference suggests they are increasingly supportive of changes to the remit, funding and organisation of local government in England.
The inevitable results of that funding shortfall is that local government faces an increasing challenge in fulfilling its statutory duty to the most vulnerable in our society. The advantage it has is that this is a problem the public understands. Nearly everyone has an elderly relative who needs help and support and can see the pressures on the system.
It is also increasingly apparent that the problems of local government finance can no longer be viewed in isolation from those facing the NHS.
There are three radical steps that should be considered if public finances are going to meet the challenge of an aging population.
The first is to recognise that local government needs to be able to raise more money, either through increased council tax, other local taxes or general taxation. Yet the public will not accept simply paying more if they cannot see where their money is going and if they cannot influence how it is spent.
That means the second radical step has to be local government reorganisation. That reorganisation is needed, not because it will save money, but because the public doesn’t understand how local government works.
The system has become ever more complex. It is such that understanding the allocation of responsibilities between tiers is now the province of academics specialising in local democracy, while ordinary citizens are left baffled.
Simplifying democratic representation is the only hope we have of persuading the voting public to tolerate the increased taxation required to maintain basic levels of social care. Scotland and Northern Ireland have already demonstrated what can be achieved through single tier systems and it would be helpful if the secretary of state clarified that, in principle, the government is supportive of the creation of unitary councils.
While the Government has a preference for elected mayors, it must be equally open to proposals for indirectly elected leaders of unitary county authorities.
The third step is to accept that local politicians should have influence over decisions about local health provision. County councillors were sceptical about whether the sustainable transformation plans will help with only 41% thinking they would improve outcomes. Equally, while there was universal support for further integration of health and social care, there was a clear feeling this needed to go further.
The NHS will need to make difficult choices between ease of access to care and the quality of that care, potentially closing local facilities. Local politicians, in collaboration with health partners, are well placed to contribute to these decisions.
Tellingly, our respondents seem to view this shift as inevitable. Some 97% thought more responsibility for health and social care should be devolved and 74% thought councillors should take a leading role in decisions about healthcare provision.
Local government has demonstrated it can manage the challenge of austerity, and 2017 could be the year local elected politicians are given the chance to increase their role in the key decisions required to deliver a sustainable and transformed NHS. That would be a radical step, but one that will make a real difference.
Ed Parker is a local government expert at PA Consulting Group