Keeping local government at the heart of reform
The Health Bill represents a significant moment for the future of health and care reform.
For councils, the central question is whether these changes will strengthen local integration or make it harder to connect national health policy with the realities of local places.
The LGA has been engaging closely with Parliament as the bill progresses. This has included a second reading briefing for MPs, and oral evidence to the Health and Social Care Select Committee’s inquiry on the bill and the Health Bill’s Public Bill Committee.
A key concern throughout our engagement has been the legislation’s proposal to remove the requirement for local authority representation on integrated care boards (ICBs).
The LGA has been clear that this is a backward step from a joined-up and localised approach.
Councils are democratically accountable to residents and responsible for services that shape people’s health every day, including adult social care, public health, housing and wider community support.
Their involvement helps ensure that NHS decisions are always grounded in local priorities and connected to the wider determinants of health, not just healthcare activity.
This matters even more as ICBs cover larger geographies. Local authorities bring neighbourhood and place-based insight, helping system decisions reflect differences between communities rather than applying a single approach across diverse populations.
Replacing that role with strategic mayoral authority representation may bring a broader regional perspective, but it cannot substitute for the detailed delivery insight councils provide.
The LGA supports the principle of neighbourhood health plans; bringing services closer to people, supporting earlier intervention and improving coordination across services strongly aligned with local government priorities.
However, we have stressed that neighbourhood health must be genuinely shaped around local communities.
Plans should be co-produced with councils, NHS partners, the voluntary and community sector, residents and people with lived experience.
Furthermore, we have emphasised the importance of health and wellbeing boards as democratically accountable forums for bringing partners together and understanding local need.
If neighbourhood health is to succeed, councils must be at the centre of shaping what it looks like in practice.
We also support the ambition behind the Single Patient Record. Better data sharing could help information follow the patient, support safer care and improve coordination between services. However, to deliver full value, the record must be interoperable across the whole health and care system, including social care.
Over time, there is an opportunity to think beyond a Single Patient Record towards a ‘Single Person Record’, reflecting wider determinants of health, such as housing, employment, education and social support.
The proposed abolition of local Healthwatch has also been a major concern. This provides an independent, statutory patient and public voice across health and social care. Removing it without a clear independent replacement risks fragmentation, duplication and gaps in accountability.
We have urged government to work with councils and partners to develop a clear and workable model for local patient and public voices that maintains independence and joins up insight across health and social care.
As the bill progresses, the LGA’s message remains clear – councils are ready to support changes, but integration, prevention and neighbourhood health will only succeed if local government is treated as an equal partner in shaping and delivering change.
- Find out more about the LGA’s parliamentary work