星空传媒

Policymakers love to talk about partnerships, cooperation, new ways of bringing agencies together, but joint working is exceptionally difficult. Sometimes it is a priority, but by no means always, and it can be a time-consuming distraction producing little tangible benefit.

So beware of some of the motherhood and apple pie in the Communities Plan. It is curious that despite all the talk of making sure housing investment is linked with "plans for public services such as schools and hospitals" there is little specific in the document about health involvement. I would be surprised if the already overstretched primary care trusts will be jumping for joy at having to liaise with yet more organisations.

Remember, these new and relatively inexperienced powerhouses of the health service are headed by a cohort of managers of whom many have never done anything like this before. They control the bulk of NHS money but are lucky if they find themselves co-terminus with any other local organisation. Meanwhile, they have a massive agenda to deliver, including government targets on everything from waiting times to cleaning up the wards. They are subject to a host of new accountability mechanisms such as scrutiny committees within councils. At the same time, much of the extra money with which they thought they were going to build the new Jerusalem will be gobbled up in rising drug costs, the cost of the European Working Time Directive, higher pay, increased national insurance costs and ever-rising demand.

So, do not expect instant enthusiasm from these hard-pressed outposts of the NHS empire. Local councils may look enviously at the levels of funding going to health but over on the other side it feels pretty challenging.

Lest all this sounds too pessimistic, though, there are areas where the health service can be expected to become involved.

First, the NHS now has a duty to tackle health inequality. As the health secretary recently pointed out, in some areas of the country life expectancy is still the same as the national average in the 1950s. The Office for National Statistics has just produced figures showing that on average, even today, a boy born in Manchester can be expected to die 10 years earlier than a boy born in Dorset. There is now a health inequalities unit in Whitehall and even some of the dreaded targets to concentrate minds. Anything else that helps achieve change is bound to gain the attention of local health leaders.

Second, the health service remains desperate for staff. Without extra professionals in key areas of housing shortage, managers know they will not be able to deliver. The degree to which the Communities Plan can deliver affordable homes in a relatively short timeframe will be a factor in this. Linking in with NHS Estates, which owns a fair bit of land, will also play an important part.

Finally, in the Thames Gateway and other new developments, the health service will have to be a crucial partner, not just as the provider and commissioner of health services but as very significant industry. In many parts of the country the NHS is the largest local employer and even in areas where manufacturing or other service industries thrive, healthcare will still be a significant player and bring large sums into the local economy.

Other agencies have never found the NHS easy to deal with and the feeling is mutual; the latest organisational reforms may make collaboration more, not less, difficult, at least in the short term. But there are common interests between the health service and the other bodies in the Communities Plan and that, more than all the Whitehall platitudes, is what will make for successful partnerships.