PF Perspectives: experts say health and social care needs urgent and radical reform

13 Oct 16

Experts brought together by PF and CIPFA as part of the Public Finance Perspectives series have concluded that urgent and radical reforms will be needed to fund the health and social care systems.

Contributors to the publication, which was launched today at a conference on health and social care called by CIPFA, include The King’s Fund’s senior fellow in social care Richard Humphries, the Health Foundation’s director of research and economics Anita Charlesworth, the chief executive of Public Health England Duncan Selbie, and CIPFA’s head of health and integration faculty Jane Payling.

Speaking at the event, Humphries told delegates that government measures to address the care crisis are “wholly inadequate in terms of what’s needed”. There has been an “astronomical rise” in delayed transfers from hospitals, he said, against a background of a 9% real terms cut in spending on social care for the ageing population since 2009.

These points were reinforced by ADASS resources joint lead, John Jackson, who told the conference that only 6% of social services directors were fully confident they can deliver the savings required to their services.

In the PF Perspectives essays, authors also highlight that the sector is facing increasing uncertainty due to Brexit and its implication for health and social care budgets, research capacity and employment prospects.

Elisabetta Zanon, director of the NHS Confederation’s European office told the CIPFA conference that the situation was totally unprecedented, and would have a significant impact on services.

Social care was identified as among the most pressing concerns by many contributors, as it must function well for the NHS to remain sustainable. However, severe funding pressure could lead to it reducing the services provided, which the experts said would have a knock-on effect on the health service.

CIPFA called for an independent commission to be convened, to consider what options are available to balance healthcare demand and supply. The institute has also called for the introduction of a ‘golden ratio’ of 10%, as the proportion of national gross domestic product that is ring-fenced for health and social care spending.

This, it argued, would reduce the unpredictability of politically-driven decisions on funding, and provide a benchmark for what the nation can afford to spend on the area. The alternative is that the public will see an increase in the rationing of services, significant tax rises or charges for using the NHS and social care.

CIPFA chief executive Rob Whiteman stated that, without radical transformation, the government would struggle to ensure the NHS and social care system will be sustainable for future generations.

“Indeed, the concerns of leading experts that CIPFA has gathered clearly demonstrate that the sector is already creaking under the strain,” he stated. “To protect services, the severe financial stress the sector is under must be confronted with great urgency.”

This meant tough and politically unpopular choices would have to be made in order to ensure the quality of health and social care services, he added. “CIPFA believes that a commission must be set up to explore these difficult decisions. It should also introduce a golden ratio of GDP spend on healthcare to protect funding from the unpredictability of short-sighted political decisions.”

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