09 March 2007
GPs should be able to provide their patients with free social care services, even if their local authority has deemed them ineligible for such help, the Department of Health has said.
Preventative care packages, such as respite care and home help are a 'legitimate use of NHS funds', as long as they will save the NHS money in the long run, the DoH's March 6 report, Commissioning framework for health and well-being, states.
The framework – which is subject to consultation – is designed to encourage greater flexible use of local NHS and council funds to promote healthy living and reduce health inequalities.
Andy Burnham, minister for health reform, said that under the new practice-based commissioning system, GPs would have the incentive to work with councils to develop 'a more sensible use' of local funds.
But he added: 'This is not a free-for-all… [it will only be eligible] where GPs can show that spending money in that way will prevent a hospital admission or will save money in the long term.'
GPs will have to present a 'business case' to their primary care trust to illustrate the saving a service could yield. The National Institute for Health and Clinical Excellence, along with a new National Reference Group for Health and Wellbeing, will publish guidance on the most cost-effective interventions.
The framework also states that, although services provided via a GP will be free, they must 'not create any liability or problems in relation to non-NHS services which are means-tested'.
Howard Stoate MP, a practising GP and member of the Commons health select committee, told Public Finance: 'The obvious bear trap is that people don't pay for health but they do pay for social care. Human nature being what it is, people will then go through their GP so they don't have to pay, and that will put an abnormally high burden back on the health service.'
The framework comes as many councils claim that, despite levying means-tested charges, they can afford to provide care services only to people with the most pressing needs. That excludes many of the early intervention and preventative services the DoH wishes to promote.
Stoate said: 'At present, local councils are complaining that GPs are cutting back on health care and so shoving more costs on to social care. The counter-charge will be that this will dump costs back on to the NHS. The possible downside is that we end up reinforcing the Berlin Wall between those services.'
Mike Sobanja, chief executive of the NHS Alliance, told PF: 'Those charged with the performance management of local authorities will be on the lookout for that anyway, so I don't think this is a short cut to sorting out budget problems.'
A DoH spokesman said: 'The details of how this will work in practice will be developed through further consultation, which will seek to work with partners to identify the practical and technical difficulties that need to be overcome.'
PFmar2007
