Social care must be included in the proposed long-term settlement for the NHS, a former health minister has argued.
Lord Darzi’s report for thinktank IPPR, published today, calls for wide-ranging changes to the current health and social care system, including replacing 244 commissioning bodies and other organisations with up to 10 new “health and care authorities”.
However, this proposal has come in for fierce criticism from the Local Government Association.
On social care, the report proposes to eradicate means testing for those with the greatest care needs. Elderly people in residential accommodation would still be expected to pay their own housing costs if they can afford to, as at present.
Lord Darzi, a Labour peer, has proposed doubling the spend on social care from £17bn to £36bn by 2030. The report recommends doing this by adding an extra penny on national insurance contributions for employers, employees and the self-employed, as part of a wider settlement for the NHS.
It is proposed the 10 health and care authorities would replace 195 CCGs and five NHS England regions. They would act as “strategic commissioners” with powers to drive integration and reform, set local priorities and ensure national standards are met. They would take over the responsibility of 44 sustainability and transformation plans and partnerships to develop new integrated care systems. The number of national NHS leadership bodies would be cut from six to three, by merging NHS Improvement, Health Education England and Public Health England with NHS England.
Lord Darzi said: “The NHS and social care have done well to improve or maintain quality over the last decade. But the cracks are now showing. We need bold action to ensure that the NHS is fit for the 21st century.
“We must demand that we do care differently by embracing new technologies and empowering people to live healthier lives. This will mean caring as much about social care and public health as the NHS and embracing reform as much as additional funding.”
Linda Thomas (Lab), vice chair of the LGA’s community wellbeing board, welcomed the report’s call for more investment in the system but added it was “a shame” Lord Darzi “doesn’t make the case for increasing the funding to councils for their core and mainstream services”.
She said also said the LGA “don’t agree” making structural changes is the way to address the challenges in the system.
“Rather than taking a new broom approach and sweeping away existing good practice through new legislation and structural changes, we should build on what we already have,” said Cllr Thomas.
“Proposals to create health and care authorities would be a major centralisation of commissioning powers away from local health and care leaders, and are a poor substitute for health and wellbeing boards that already exist with a range of powers and duties.”