Labour promises integration of social care
25 January 2013
Full integration of health and social care to deliver ‘whole-person care’ is being advocated by the Labour Party as it reviews its health policy.
Shadow health secretary Andy Burnham, in a speech entitled Whole-Person Care: A One-nation Approach to Health and Care in the 21st Century, said yesterday that a Labour government would keep CCGs (clinical commissioning groups) but would ‘repeal the Health and Social Care Act 2012 and the rules of the market’.
Announcing the launch of a six-month health and care policy review at the King’s Fund, Mr Burnham suggested local authorities and health and well-being boards could take a prominent role, working in partnership with CCGs, on commissioning with a single budget.
The review, to be led by Labour shadow minister for care and older people Liz Kendall, will seek views from the public and key stakeholders on two key questions:
- Is it time for the full integration of health and social care?
- How far do people wish to go towards integration?
Mr Burnham said: ‘We could get much better results for people and much more for the £104bn we spend on the NHS and the £15bn on social care, but only if we turn this system on its head.'
BMA council chair Mark Porter said Mr Burnham was asking the right questions.
Dr Porter said: ‘The big problem is that these questions have to be looked at in the context of the current disruptive reorganisation of the NHS and funding cuts, which make the rational planning of integrated health and social care very difficult.
‘Making this vision work would not be easy without further significant change, and the last thing the NHS needs is another major reorganisation.’
He added: ‘There are important questions about how a single budget would work in practice. It would require very effective coordination between the NHS, local government and other sources of funding, which would create new challenges.’
No top-down reorganisation
In his speech, Mr Burnham said: ‘Our fragile NHS has no capacity for further top-down reorganisation, having been ground down by the current round. I know that any changes must be delivered through the organisations and structures we inherit in 2015.’
Mr Burnham said gaps between the NHS, mental health services and social care were getting dangerous and people wanted care to be coordinated, but this was unlikely in the existing three-service system.
He said Labour wanted to get incentives in the right place to invest in prevention with a ‘one budget, one service’ model. This could include acute hospital trusts being paid to care for patients in their homes instead of admitting them, he added.
On service reconfiguration, he suggested that local general acute and emergency provision could be protected if people accepted changes to some parts of hospitals.
On competition, he said: ‘NHS hospitals need the security to embrace change, and that change will happen more quickly in an NHS-preferred-provider world rather than an any-qualified-provider world, where change is an open tender…
‘Rather than allowing the NHS model to be gradually eroded, we should be protecting it and extending it as the most efficient way of meeting this century’s pressures.’
However, he added: ‘There are dangers of monopolistic or unresponsive providers.’