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Labour’s plan to better integrate health and care

The Labour Party has unveiled its 10-year plan for the NHS saying that while there would be no top-down, major reorganisations, they will develop a more integrated health and care system.

Labour leader Ed Miliband said the implementation of his national vision of integrated health and social care will be evolutionary.

Improving home care services is a key thrust of the plan. Health and Wellbeing Boards would become accountable for ‘year of care budgets’ which would cover the health and social care needs of those at the greatest risk of hospitalisation.

Providers would bear the costs if the health of patients under the budget deteriorated and they needed expensive hospital care. It’s aimed at tackling the problem of 15 minute social care visits.

Andy Burnham, shadow health secretary, said: “If social care in England is allowed to collapse, it will drag down the rest of the NHS. [It] is a root cause of the crisis in [accident and emergency]. For the want of spending a few pounds in people’s homes on decent home care, we are spending thousands of pounds keeping older people in hospital, even when they are able to leave. The increasing hospitalisation of older people is no vision for the ageing society.”

Burnham confirmed his desire to “work towards the notion of a single [health and social care] budget; a single budget for children and then a single budget for adults”.

Labour would also repeal key elements of the coalition’s Health and Social Care Act. Statutorily enforceable rules on NHS competition would be unpicked, with Labour claiming that £100m in savings could be generated by scrapping the competition rules.

Miliband endorsed the ‘NHS preferred provider’ policy saying the private sector has a role but as a supplement rather than a substitute.

Miliband said: “We can only join up the services when we have the right values at the heart of our NHS: care, compassion and cooperation, not competition, fragmentation and privatisation. These aren’t the values of our National Health Service. These aren’t the values of the Labour Party. These aren’t the values of the British people.”

Much of the detail in the 10 year plan has already been announced, particularly plans to recruit extra GPs and nurses. However, the announcement of a “new arm of the NHS” comprised of 5,000 home care workers employed within the health service is significant.

The home care workers would focus on “those with the greatest needs, including the terminally ill so they can stay with their family at the end of life, and those who are leaving hospital who need extra help if they are to move back into their homes”.

There is as yet no detail on the training and qualifications these employees would have, what kinds of organisations would employ them, or how much they would be paid.

Labour has pledged to pay for these new employees with a previously announced mansion tax, a levy on tobacco firms and a crackdown on tax avoidance.

It would also cut bureaucracy, raising doubt over the continuance of arm’s length bodies created by coalition legislation, such as the NHS Trust Development Authority and NHS England. Other potential targets for savings could include NHS commissioning support units, or clinical commissioning groups.

Labour also said it would enter into a new ‘compact’ with the 1.3m NHS staff to “lift morale and improve patient care”.

This would include appointing a new ‘NHS staff champion’ responsible for improving workplace culture and reducing bullying, work-related stress and sickness absence.

It follows the pay dispute between unions and the coalition government over its decision to reject the NHS Pay Review Body recommendation of a 1% pay rise for all NHS staff.

If Labour wins the general election in May the party says it will “recommit to the Pay Review Body process and pledge not to renege irresponsibly on pay deals like current ministers”.

Miliband said: “What our 10 year plan is designed to do is give people a sense of direction – there is a sense of direction, there is a party with a plan for where the NHS goes. We’re not sort of chopping and changing, we’re not doing what this government has done in instigating, a top-down reorganisation, but are giving a clear sense of direction.”

The leadership, however, is facing a backlash by Tony Blair supporters who have warned that his plans for the NHS risk playing into Tory hands.

Former health secretary Alan Milburn said the party was running a pale imitation of its losing 1992 general election campaign, as it retreated to its comfort zone over the NHS rather than setting out a strong economic vision.

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One Response to “Labour’s plan to better integrate health and care”

  1. Malcolm Morrison says:

    There can be little argument that ‘the diagnosis’ is (largely) right! It is clear that the combination of an ageing population (many of whom live alone) and the lack of ‘care in the community’ is responsible for the ‘bedblockers’ – and attendances at A&E. All examples of ‘demand exceeding supply’.

    Way back in the 1970s, we had a ‘DHSS’ (Dept. of Health AND Socila Security) – but the two were split by politicians! (I was told because the ‘budget’ was too big!). The principle of a ‘shared budget’ between health and social care is, obviously, a good one – but my experience of where these have been tried is that there is a huge argument as to how much each organisation should ‘put into the pot’ – especially when both are ‘strapped for cash!

    I was heartened to hear a Health Minister, on the TV news yesterday, calling for an ‘all party’ groups to look at the problmes – but it really needs to be an ‘independent’ body including lay people (the users) and professionals (staff) if they are going to begin to address the fundamental problem of ‘demand exceeding supply’.

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