Greater Manchester CA is to bid to pilot the provision of social care funded through a wealth tax “on the NHS principle” of free at the point of use , mayor Andy Burnham has said.
Speaking to Health Service Journal last week Mr Burnham said he had concluded that “Westminster will not solve” the problem of social care funding and confirmed the CA was due seek permission from the government to introduce a form of wealth tax and provide free social care support for all as part of its Budget submission.
Mr Burnham said: “My argument to the government in this Budget is to come at it from a different angle. Having raised social care in the general election campaign, you can’t just drop it now and say ‘that was too difficult we’ll forget about that’.
“Come at it in a different way by using the opportunity that Greater Manchester provides to see if we can pioneer a new way of doing things.”
He added that discussions over health and social care integration, including some structural changes, would leave organisations with no “vested interest to make it real”.
Mr Burnham added: “What I’m absolutely clear on is moving to a world where social care is funded on the NHS principle.”
A combined authority spokesperson told LGC that no further details on the pilot proposal were available as the bid was still being finalised.
The Conservative election manifesto proposed people should be responsible for paying for their own care by using their property wealth – but with a £100,000 “floor” beyond which their assets are protected. However, this was heavily criticised and the party subsequently sought to insert further conditions.
The idea of a new wealth or inheritance tax – raising money from people’s property assets – was branded a “death tax” by some national newspapers when Mr Burnham proposed it during his time as health secretary in Gordon Brown’s government.
In the interview with HSJ Mr Burnham also said health leaders in Greater Manchester should reflect on the much heralded reconfiguration of hospital services in the region, saying it “took time, energy and focus away from where it should have been”.
He said the region’s Healthier Together consultation “came at the wrong end of the telescope” and efforts should have focused on health and social care integration.
Although the Healthier Together process included workstreams on primary and community care, the public debate and much of the senior leadership involvement was dominated by the controversial plans to consolidate emergency general surgery at four hospitals.
Engagement around the project started in 2013, with a final decision made in July 2015. The eventual unanimous decision by commissioners and subsequent failure of a judicial review was hailed within the NHS as a major success for the Greater Manchester health economy, and a boost to the region’s devolution programme.
More than two years later, the changes are still to be implemented, however funding has been secured and business cases agreed.
Mr Burnham, who was shadow health secretary and Leigh MP in this period, did not oppose the plans during the consultation and agreed there was a case for change.
But he told HSJ: “People need to reflect on why Healthier Together was so problematic. I think what happened was it went for quite a high end, quite narrow focus, which was emergency surgery affecting quite a small group.
“It didn’t really look at the whole question around integration. It almost came at the wrong end of the telescope, I think. It took a lot of time, energy and focus away from where it should have been.
“My view would be: don’t do a traditional thing [such as how to close or consolidate services] that the health service obsesses on, go for the big picture.”
The submission also calls for the region’s transformation fund, which is worth £450m over five years, to be extended.
Although some progress has been made to better integrate services in the region, in boroughs such as Salford, the current legislation and tax laws have prevented the type of full integration Mr Burnham would like to see.