Speeches by Coleman.

“Are we talking about housing as well? And do you think that the NHS understands sufficiently how those things operate in local authorities?”

“That is very helpful. You talk about the relationship with social care. Even in social care, I feel that local authorities have a much better understanding of the NHS than the NHS has of local authority social care provision. But are we just talking about social care when we are talking about local—”

“It gives us things to look forward to. It was very encouraging to hear what you said about the disabled facilities grant. I think you are saying that occupational therapy is a good profession to go into under this Government. Is that right?”

“When you say “we” need to do that, I presume you are talking about the NHS and the Department of Health and Social Care. What action are you specifically taking to ensure that the NHS takes the trouble to understand local authorities, how they work and what they can do better than now? At the moment, it is still very t…”

“I am extremely encouraged by what the Secretary of State is saying. In my constituency—I have been following this for well over two years—the amount of sewage discharge has been absolutely contemptible. In 2023 alone, Thames Water pumped sewage into the river 116 times, for 990 hours, even when it was not raining. I am…”

“May I suggest that if the right hon. Lady wishes to see the situation in the Thames, she need only go three bridges downstream to my constituency of Chelsea and Fulham, where the people who live in the Chelsea Reach houseboats regularly send me photos of the dirt and sewage coming down the river after 14 years of absol…”

“What is the voluntary sector and what is the community sector? I looked at your board and that position is vacant at the moment. Is that because it is challenging to fill?”

“Can I come in on that question?”

“Oh, to be the chair. Thank you.”

“They were interviewed for? In local councils, they are not all interviewed for; the council just puts up the person it thinks is best for the board.”

“I have a final question, which is for you, Saffron, although it could be for anyone. I have noticed that on some integrated care boards you have a chair who is from a local authority background and a chief executive who is from the NHS. On other boards, both positions are from the NHS. Some integrated care boards have …”

“Brilliant; that sounds very impressive. When it is done, how will you evaluate and share the learning?”

“Thank you. I am sure we can come back to what the challenges are with the other witnesses. Stephanie—sorry to put you on the spot again—I want to come back to the new community care partnership that you have appointed. You went and commissioned the services, but how easy was it to get agreement among all the partners w…”

“Why do you think it comes out so late? All the local authorities are waiting for it—they are waiting and waiting and waiting, and so are local NHS partners—and it comes out so late. Is there something systemic at the centre that needs to change?”

“And they all operate in their own sweet way. There are a couple of things that I would like to bring out. One is the role of councillors, and the other is the better care fund, because we talked about the funding. I will ask Melanie to pick that up and talk about the agony, from the local authority perspective, of havi…”

“Thank you. That is very interesting. I shouldn’t pick out your board, Stephanie, because there are how many ICBs in the country now?”

“Thank you very much. Saffron, do you want to talk about how we can improve the understanding between the different parties?”

“That is very interesting and helpful. To follow up on that, you have appointed a private sector provider to bring together everybody and do something new in children’s services. Is that because you could not get skills locally, or was it simply that bringing someone in from outside who was neutral was an easier way of …”

“To come back to my original question, where are the greatest tensions? Are they between different parts of the NHS that do not want to work together, or are not used to working together, or are they between an NHS that does not understand the local authority and vice versa?”

“I see Stephanie wanted to come in on that.”