Double spend on care to make it free for all older people, says report

20 Jun 18

Care should be free for all older people who need it, according to a report by former health ministers.

This would require the current £17bn free personal care funding in England to be more than doubled to £36bn by 2030, according to the Lord Darzi Review of Health and Care published on Friday last week. 

The report, commissioned by the Institute for Public Policy Research and written by Lord Ara Darzi and Lord David Prior, said that free social care would reduce the cost elsewhere on overall health and care spending for older people.

The authors cited the case of Scotland, where care funding is free for older people, and saying “increased spending on social care [there] has resulted in lower spending overall on health and care for older people”. 

Darzi previously recommended that raising national insurance contributions by one pence in the pound could deliver £350m extra a week for the NHS.

Cuts to social care funding over the last decade have led to an average fall of 5% annually in the number of people receiving state-funded care, the peers said.

The NHS is also spending £3bn a year on looking after hospital patients who could be discharged, but who do not have sufficient support at home.

Former Labour health minister, Darzi, said the NHS and social care have done well over the last decade but added that “the cracks are now showing”.

He identified a need for “bold action” and said “this will mean caring as much about social care and public health as the NHS and embracing reform as much as additional funding”.

The report called for “radical simplification” of the NHS by undoing some of the 2012 Lansley reforms that separated acute and community care commissioning, and primary care commissioning.

Darzi and Prior proposed the creation of ten new health and care authorities, which would replace 195 CCGs and five NHS England regions.

Merging NHS England, NHS Improvement, Health Education England and parts of Public Health England, was another suggestion.

Ex-Conservative health and business minister, Prior, called for a shift from ‘diagnose and treat’ to ‘predict and prevent’.

“A universal service should be there for everyone, not the same for everyone”, he said. 

“At the heart of our plan for reform is a radical simplification of the NHS and a properly funded social care system to make this happen”.

Linda Thomas, vice chair of the Local Government Association’s community and wellbeing board, said it was a “shame” that the report did not call for increased funding for councils and their core services.

She also warned that proposals for ten HCAs would take commissioning powers away from local health and care leaders.

A Department of Health and Social Care spokesperson said: “This government is committed to ensuring that everyone has access to the care and support they need, but we are clear that people should continue to expect to contribute to their care.”

Social care leaders this week called for their sector to receive a funding boost similar to the £20.5bn over five years injection Theresa May announced for the NHS on Monday. 

The social care green paper has now been delayed until the autumn, to come out around the same time as a 10-year plan for the NHS.

May told the NHS to produce the plan as part of her funding announcement on Monday and asked that it reduce inefficiencies in the health service. 

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