Health and Social Care Funding Reform

The Sunday Telegraph, 22nd November, carried an article from Lord Forsyth of Drumlean, chairman of the House of Lords Economic Affairs Committee and who’s employment history includes being a minister under Margaret Thatcher’s government. The Telegraph newspaper is a former employer of the current Prime Minister Boris Johnson (he was a columnist in the period immediately prior to winning the election in 2019) and sometimes used as a kite flying venue.  It is worth exploring what the article says.  

There are two main proposals. Firstly, there should be provision of emergency funding now to meet the growing demand for services and give care workers a much needed pay rise. This is vital in ensuring people get the care they need. 

And, then by the end of the parliament there should be a commitment to making care (as opposed to accommodation costs for residential care) ‘free at the point of need’, just like the NHS. 

The author then goes on to say: 

“Crucially, these changes in funding should be made alongside bold reform in how the system works, with steps taken to join up care with the NHS, and to help keep as many people in their homes for as long as possible. 

Of course, all of this will not come cheap. 

To deliver these two big changes we will need to spend over half as much again on care as we do today by the end of the parliament. In time this will undoubtedly require us to find additional tax revenue. 

But, after decades of underinvestment in care, loosening the purse strings was always going to be required. In truth, the cost of these measures by the end of the parliament would amount to £9bn per year, compared to the furlough scheme which is likely to cost about £6bn per month. 

Moreover, investment in social care will not only cost money but save money too by freeing up capacity in the NHS which can be redeployed to deal with the backlog created by the pandemic.”

Those of us with long memories may recall that we have been somewhere near here before. In the Blair years “local strategic partnerships” were encouraged in which all statutory bodies were encouraged to work together to provide joined up services. So, care beds and care provisions were to be made available which would enable “bed blocking” to be resolved. In turn, this would then mean that hospital beds were available for people who needed them – and not care beds. It will be interesting to see if the second proposal gains traction and, if so, how? It is certainly one for the sector to keep an eye on.  

The first proposal has financial implications. If there is increased funding it will go to commissioning bodies. They will then have the choice to pass on the additional funding, in the form of increased contract prices linked to remuneration of delivery staff or retaining it to use elsewhere. This is something where there does need to be a sector wide approach. Staff remuneration is a key factor in staff retention. Increases at the lower end of pay structures is a good thing in this regard. However, the danger of a flatter pay structure is that there is less willingness to progress, which may affect working experience in key management roles in the future. 

Andrew Rainsford Policy & Research Officer VSNW

To note: The Telegraph operates behind a paywall and therefore access to the article requires membership or signing up for a one month free trial.