We can't afford NHS, says Lord Sutherland

11 Jul 13
The National Health Service cannot be afforded long-term in its present form, Lord Sutherland has told the CIPFA conference.

By Mark Smulian | 11 July 2013

The National Health Service cannot be afforded long-term in its present form, Lord Sutherland has told the CIPFA conference.

Sutherland, who chaired the 1999 Royal Commission on The Long-Term Care of the Elderly, said greater longevity would cause serious financial problems for health and care services as larger numbers of older people came to depend on them. He spoke as an NHS England report identified a £30bn funding gap by 2020/21.

‘I don’t think we can any longer afford the health service we have,’ he said, adding that it was necessary to get away from a situation in which any criticism of NHS spending was like ‘criticising the Church of England’.

He attributed much of the problem in financing health and social care to a ‘fissure’ created 60 years ago when the NHS and social care were set up as separate systems, the former national and the latter local.

‘Health is a national service free at the point of delivery while social care is radically different, local and not free.’

The result was that it was impossible to join up the budgets for the two services, so both wasted resources.

Sutherland gave the example that people might have to remain in hospital longer than necessary because a local authority had no social care space for them, and even if it had might be unwilling to provide it as any saving would accrue to the hospital.

‘We must try to get rid of these perverse incentives in the system,’ he said. The £3.8bn that last month’s Spending Review would take from the NHS and give to social care was ‘a good start but does not tackle the systemic problem'.

Answering a question from Andy Burns, finance director of Staffordshire County Council, Sutherland said he inclined to ‘a national care service rather than a local health service’, since this would allow care benefits to be uniformly available to people as they moved around the country.

Anand Shukla, chief executive of the Family and Childcare Trust, said its detailed study of 11 families had shown even those in higher income groups were only ‘a couple of steps away from financial shocks’.

Costs of living, cars, credit and childcare combined to leave families in precarious financial circumstances, he said.

Shukla said families should be regarded as engines of economic growth, which enabled people to engage in education and work, not simply as a cost to the state.

‘Putting families first will allow us the benefits that thriving families bring to the economy,’ he said.



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