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Editor's blog Thursday 21 October 2010: Has the DH stitched up Total Place?

Total Place - what a laugh, eh?

Like Tony Blair, it was the future once.

Then pre-coalition, senior Tories were briefing like mad that it was on the way to the mortuary along with every quango - apart, obviously, from the new, good quangos: Office For Budget Resposibility, NHS National Commissioning Board.

Latterly, the noises coming from the highways and byways of Whitehall suggested that it was not going to be abolished. Perhaps just renamed.

Now Public Finance reports that the dear old Department of Health may have administered the kiss of death to spreading the concept.

PF"s Jaimie Kaffash quotes local government select committee chair Clive Betts as saying, "I think generally there is cross-party consensus on trying to get more devolution, more power to local authorities. And I think there is consensus in the DCLG. The problem is, we have not got cross-Whitehall consensus, getting other departments to sign up. It is something that there is lip service but to, but there is no real enthusiasm.

"The Department of Health was totally and utterly resistant. Its view was that any money spent by the department was accountable to the secretary of state and he alone was responsible for every penny spent.

"I think there is a long way to go".


Assuming as I am that the quotes are correct, this strongly indicates that the right hand does not know what the further-right hand is doing.

It could not conceivably be more clear that the way forwards is about sharing and moving preventative services into the community. The NHS has just shared £1 billion of its capital budget with social care.

Lessons from the personal budgets programme; the evidence from the care trust pilots ... it's just too obvious that old-school turf wars to stop needful things such as place-based budgeting are a sad, if unsurprising, sign of a retreat to silo mentality rearing its ugly head.

The choice is simple for the Department of Health (as for pretty well all the public sector). If you want to get through the next few years, you hang together - or you all hang separately.