Birmingham City Council’s chief executive questioned whether social care should be taken over by the NHS.
The chief executive spoke in a fringe session in Brighton at the Society of Local Authority Chief Executives and Senior Managers annual summit.
Dawn Baxendale said: “I’m just coming to the conclusion we have a David and Goliath situation between health services and social care.
“I don’t think David is going to win in this situation.
“Because of where the NHS sits in the national psyche, should it be one system? Should we be running social care at all?”
Ms Baxendale called for a national debate about the sector’s status and urged a ‘genuine understanding’ about social care’s plight.
The Care Quality Commission’s chief inspector, Andrea Sutcliffe, suggest new silos could emerge.
She said: “Even if social care came into health – and I’m not arguing that it should, there would still be a boundary with housing.”