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Lamb: NHS cannot fund social care reform

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Care services minister Norman Lamb has said social care reform should not be funded from the NHS budget because the health service is already under financial pressure.

Health reporting HSJ and LGC logo

Mr Lamb was speaking at a fringe session of the Liberal Democrat conference in Brighton on Monday night.

He said reforming social care funding to protect those who face “catastrophic” costs in old age was a “sensible and justifiable thing to do”.

However, he said implementing the findings of the Dilnot commission on social care funding would cost £1.7bn and “you can’t fund it from existing resources because they are under intense strain”.

“The only way in my view you can do it is find a new funding stream where there’s a sort of consensus, an agreement across political parties,” Mr Lamb said. He said this could be reached through a process similar to that used by the previous Labour government and chaired by Adair Turner, to reach a settlement on pensions.

Later, he told LGC’s sister title Health Service Jouornal that although the NHS could achieve “significant efficiencies” to meet the £20bn Nicholson challenge, “to take £1.7bn off at the same time as you are trying to affect a change in the system and achieve efficiency savings is a big ask”.

“You have to either find [other savings], and I struggle to see how you can do that in health and social care, or you find some new money.”

Mr Lamb said any settlement must also be “generationally fair”. “In my view you can’t expect working age people who are already under enormous pressure to incur further cost to care for older people,” he said. “But if you can pool cost across older people in order to protect people against catastrophic loss… then I think you would achieve something of real value.”

He also made the case for funding social care through taxation. “It’s about everybody showing solidarity to care for people at their most vulnerable. That’s valuable and should be protected”.

Mr Lamb also revealed that he has convened a “round table” to drive integration of NHS and social care services, to meet for the first time “in the next few weeks”. He told HSJ the group will include representatives from the NHS Commissioning Board, the King’s Fund and the Nuffield Trust. It is the first indication of how the new ministerial team, appointed earlier this month, will work with the board beyond the mandate to influence the provision of NHS services.

In a series of speeches yesterday Mr Lamb attacked the “institutionalised fragmentation” of services, describing the splits between primary and secondary care, mental and physical health, and NHS and social care services as “crazy”.

“It complements the mandate,” he said. “The mandate in draft form is OK – it’s good on integrated care. But we need to give it the political impetus to make it happen.”

“There has to be a ruthless focus on integrated care,” he said.

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