Essay: Integrated care systems and strategic authorities
Coming together to tackle health inequalities and the wider determinants of health Strategic authorities and integrated care systems are increasingly…
Over the last 30 years, Britain has shifted from having a market economy to being a market society where large swathes of public services are outsourced to the private sector. Within adult social care, local authorities have become strongly reliant upon large providers who extract wealth from the care system, wealth that could otherwise be used to generate social value, providing additional benefits for citizens and the state.
We need to re-animate the demand of decency for service users over dividends for shareholders and to return to a system where the default position is state delivery of services in conjunction with alternative models of ownership, such as community businesses, social enterprises, co-operatives and the like. To this end, this publication provides both a policy and practice guide for local government.
Section one, provides an analysis of the policy context within adult social care with a view to arming local politicians with a realisable vision to advance alternative models of ownership. Section two highlights examples of where progressive activity is taking place to provide inspiration for other commissioners and policymakers to adopt similar practices. Finally, in section three, this paper offers recommendations to address how this progressive practice could be scaled-up and amplified further, despite the challenging national policy context.
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