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Burnham outlines new role for Monitor

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A Labour government could put Monitor in charge of overseeing the financial sustainability of whole health economies and driving integration between different organisations, Andy Burnham has told LGC’s sister title Health Service Journal.


The shadow health secretary also revealed during an exclusive interview with HSJ at the party’s conference that the £2.5bn NHS funding boost announced by Ed Miliband would be repeated for every year of the next parliament, and further outlined plans for hospitals to become “integrated care organisations”.

Mr Burnham spoke to HSJ following his address to conference in Manchester in which said he wanted to bring social care into the NHS as part of a 10 year plan.

He also wanted to develop a system focused on whole person care that pushed provision out of hospitals and into communities.  

“I have been thinking about what the future role is for Monitor,” he told HSJ. “Removing the competition role is absolutely essential, but I don’t want to lose the financial rigour that it brings.

“I am now going to give serious consideration to a proposal to make it Monitor’s job to be about two things.

“Number one: fostering of integration, and number two: financial sustainability of whole health economies, not of the individual players.”

The former health secretary said he was “not 100 per cent committed to the idea” which he said was first proposed by think tank ResPublica.

But he wanted to see what people’s “appetite” was for a “potentially major development”.

“The idea would be to help people look across their patch and help people develop a plan to make the whole thing sustainable,” he said.

“It would look at how the year of care [tariffs] can work across everybody; it would put that bigger picture together.”

Under year of care tariffs, NHS providers are paid for providing care to patients for a year rather than individual episodes of care, such as hospital admissions.

The Monitor proposal would likely hand the organisation a role akin to a system manager, potentially similar to the role of strategic health authorities, which were abolished last year.

The system manager role would potentially be necessary in the absence of a market economy, which Mr Burnham has said he wants to abolish while installing the NHS as the “preferred provider”.

While Monitor currently focuses primarily on the health of individual organisations, it is taking part in a review of “challenged health economies” alongside NHS England and the NHS Trust Development Authority, launched earlier this year.

This will ensure the financial regulator of foundation trusts has a track record of working beyond single trusts ahead of next year’s general election.

Mr Burnham also revealed the £2.5bn of extra funding unveiled by the Labour leader in his speech at the Manchester conference on Tuesday would be available in every year of the next parliament from 2015-16.

“A full spending review has not been done yet, so that’s the first thing to do,” he said.

“It starts with [shadow chancellor] Ed Ball’s statement that we will do whatever it takes to protect the NHS.

“This is recurrent funding.

“So the money starts to come in and it’s there and this becomes part of the NHS budget. It’s great news for me…This is money over the five years of the parliament that we can bank on basically.”

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