Integrating with integrity

Philip HuntPhil Hunt goes behind the spin of the government’s adult social care proposals

With the country facing so many formidable challenges, last week’s Queen’s Speech was an ideal opportunity for the Coalition to outline a positive agenda for jobs and growth and to help hard pressed families cope with a drastic fall in living standards. Instead, we were treated to a desperately disappointing and dispiriting programme from a government that is out of touch and out of ideas; and indeed, out of support from a significant number of its own MPs.

Nowhere is this failed stewardship so much in evidence than in the field of health and social care. 

Hospitals are full to bursting; discharges are becoming ever more difficult; handovers to social services are slower and subject to more disputes; and social care and the voluntary sector are struggling to fulfil demands placed upon them. And at national level, there is utter confusion as to who is in charge – including the recent spectacle of NHS England wrangling with the Health Secretary over the release of money to help hard pressed A&E services. No wonder the Chief Executive of the Foundation Trust Network described the government’s response as “an omnishambles”.

Following our lead, Ministers have now been forced to announce new measures to get the NHS and social care working together in integrated teams. But, having ignored our warnings, their enforced marketisation of the health service has already encouraged service disintegration. Putting it bluntly, the announcement lacks integrity.

The recent report of the Association of Directors of Adult Social Services laid bare that the scale and severity of the financial squeeze that has stripped £2.7bn from social care services since 2010 – equivalent to 20% of care budgets – at a time when demand continues to rise. 

The Coalition claims that its Care and Support Bill, which gets its Second Reading in the Lords next week, will ensure the elderly do not have to sell their homes to meet the costs of care. 

It certainly builds on many of the recommendations of the Law Commission’s review of adult social care legislation, initiated by the previous Labour government, and the proposals in our White paper before the last election. But while the bill may be a step towards a better system, it won’t go anywhere near far enough to tackle the current crisis engulfing social care. Nor will it help those now facing a daily struggle to get the support they urgently need. And new rights to services and support risk being meaningless as local authority budgets are cut to the bone. The reality beyond the Coalitions’ spin is that people’s savings are being washed away. Ministers are promising to give a little in the future whilst social care provision is collapsing. 

We need a genuinely integrated NHS and social care system which helps older people stay healthy and living independently in their own homes for as long as possible. That’s why Labour’s vision of whole person care is so important. 

People don’t fit neatly into the separate categories of physical, mental and social care. Whole person care means meeting all of a person’s needs together in a single care service and, with a single budget, would create a powerful incentive for early intervention and community support. 

This issue is one of society’s greatest challenges – and something we need to tackle with great urgency. In the absence of any such vision from the government, it will be Labour’s mission to achieve.

Lord Phil Hunt of Kings Heath is a Shadow Health Minister and Labour’s Deputy Leader in the House of Lords

Published 14th May 2013

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