DHSC scotches Scottish example for free care

A new review calls for current free personal care funding in England to be doubled – to make care free for older people who need it.

The Department of Health and Social Care (DHSC) has scotched the Scottish example of free care funding for older people as applicable for England.

A new review says care could be free to all older people who need it if the current £17bn free personal care funding in England is more than doubled to around £36bn by 2030.

That review, commissioned by the Institute for Public Policy Research and written by Lord Ara Darzi and Lord David Prior, cites free care for older people in Scotland, saying: “Increased spending on social care [there] has resulted in lower spending overall on health and care for older people”.

But in a statement, DHSC effectively ruled out the Scottish option, saying: “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 have a funding boost similar to the £20.5bn over five years ‘devil in the detail’ injection Theresa May announced for the NHS on Monday.

Darzi has previously recommended raising national insurance contributions by one pence in the pound, which 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 and 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.

Darzi, a former labour health minister, identifies a need now for “bold action” that would mean caring as much about social care and public health as the NHS and embracing reform as much as additional funding.

Niall Dickson, chief executive of the NHS Confederation, said health and social care had reached a “watershed moment” with Lord Darzi right to identify significant action as absolutely essential.

Dickson referenced a recently commissioned Ipsos Mori poll which suggested 82% of the British public backed a spending uplift in this sector.

“Similarly, we agree that systems need to be simplified, locally led and patient centred with care shifted away from hospitals and into the community.

In particular there needs to be more investment in primary care – the new long-term funding deal announced by the prime minister simply will not work if we carry on doing the same things in the same ways,” he said.

The Darzi report also calls for “radical simplification” of the NHS by undoing some of the 2012 Lansley ‘reforms’ separating acute and community care commissioning, and primary care commissioning.

Darzi and Prior propose the creation of 10 new health and care authorities, which would replace 195 CCGs and five NHS England regions – while merging NHS England, NHS Improvement, Health Education England and parts of Public Health England, was another suggestion.

Prior, former Tory health minister, sees a shift from ‘diagnose and treat’ to ‘predict and prevent’.

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

“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 LGA 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 10 HCAs would take commissioning powers away from local health and care leaders.

The release of the government’s social care green paper has now been delayed until the autumn – when the 10-year plan for the NHS is due.

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