I will attempt in this essay to specifically explain the meaning and implications on the imminent challenges that may be experienced while trying to achieve this objective. I will include the political considerations of the devolution of power from central government to the regions and local authorities. Also, I will look at the political willingness, and what government departments do, to pay attention to a stronger patient voice in this process. I will critically analyze the functions and compositions of public forums in the UK since the onset of this idea of transition from central government. Issues of partnerships and service delivery policies will also be discussed with the intention of shedding more light on their role in ensuring that citizens in this country get better health care through a decentralized framework. I will also draw on some internal documents and discussions within the central Department of Health to represent up to date changes taking place in the move towards decentralization. Organizational
Initiatives such as Local Area Agreements (LAA's) and Local Strategic Partnerships (LSP's) will also be discussed at length in terms of their extensive utilization as key instruments in the health and social care sector in decentralization.
Local Area Agreements are public initiatives designed to specifically handle issues of coordination between the central government, partnerships and the public in general on matters of social and health care. They are usually agreements between the central government, the local government and other major partners who take part in the provision of solutions to local issues. They are structured to promote safety among the societal members in terms of strengthening communities and to implement strategies necessary to safeguard people in the society through improved health and social care programs.
The objectives of Local Area Agreements are to:
help in linking up public services at the local level to the central government
aid decision making processes at local levels of authorities
reduce the number of funding channels that are used to convey funds to local authorities, and to
Promote structural partnerships among different groups of people. (Jeffrey A. & Ashman P, 2001)
Local Strategic Partnerships
LSP'S are non-statutory organizations designed to enable important decisions to be made at local level so that issues that need to be addressed at the community level are dealt with efficiently (ODPM panel report, July 2004). It also brings together the public, governments, private sectors and other interested parties to the community level to discuss issues that affect the people. In the UK, Local Strategic Partnership programs were developed in 2003 by a consortium of peer reviews to promote collaboration of performance management systems in the health care sector. (Democratic Health Network, 2006) It was designed to ensure that there is widespread ownership between the partners and communities. The peer review process involved various stakeholders who helped in outlining and promoting new experiences and insights about good practices on public health. Since that time, Peer review programs have been reviewed including the Coventry proceedings in October, 2003 which allowed for the scrutiny of how partnerships behave and act