A proposed merger of health and social care would be the biggest shake-up of the NHS since its creation in 1948
"Unified health and social care budgets are the only way to deliver both a more efficient health and social care system as well as properly joining up for the benefit of patients what is currently a badly fragmented system." Dr Dan Poulter, former health under-secretary and NHS psychiatrist
The government is considering creating a new national care service, in which health and social care would be delivered by the same organisation, according to the Observer.
Currently social care is delivered by local authorities. Because they are underfunded, there is little incentive for them to provide better care. In many cases it is easier for them to transfer people into hospital, where the cost of care will come out of the NHS budget.
In principle, an integrated service could potentially deliver better care and free up NHS beds across England, but health and social care secretary Sajid Javid is said to be considering how such a service might work in practice. If the proposal is found to be feasible, then it will appear in next month’s white paper, and will likely include national standards for care. A change of this magnitude would be the most significant reform of the NHS since it was founded in 1948.
The Observer, which based its story on information from senior government sources, said that prime minister Boris Johnson had been keen to announce plans to integrate health and social care services last month when he revealed that National Insurance contributions would rise by 1.25 percentage points to raise £12bn a year for the NHS and social care. The announcement was put back, however, because at the time it was unclear how an integrated system might work.
One option the government is said to be considering is that of removing all responsibility for social care from local authorities. This could prove unpopular, however, given that local authorities have already lost many of their responsibilities, including education.
The former health under-secretary Dr Dan Poulter, who works part-time as an NHS psychiatrist, told the newspaper: “If integration is to be a success, it is essential that reform does not just deliver parallel commissioning of health and care services but also services commissioned through a single pooled budget. Unified health and social care budgets are the only way to deliver both a more efficient health and social care system as well as properly joining up for the benefit of patients what is currently a badly fragmented system.”
Former Tory Cabinet Minister Damian Green, said that running social care jointly between local authorities and the NHS was an “interesting idea” but added that it would “still leave big questions about how you attract a bigger and better paid workforce, how you ensure appropriate housing so that people do not go prematurely into residential care.”