The Future Of Care Will Be ‘Integrated’

Welcome to ‘Inside Politics’, PLMR’s monthly review of the political developments affecting the care sector. We’ll be helping you negotiate the political landscape, reporting on relevant developments in Westminster and beyond. Let’s start with a couple of phrases you’ll be hearing again and again as we run up to a General Election over the next 18 months or so… ‘integrated’ or ‘whole-person’ care.

Figures from across the political spectrum have been using these buzzwords a lot; the Health Secretary, Jeremy Hunt, told the Guardian he wants to “integrate social care into the NHS, so that the same system which takes medical care of us also looks after us in old age.” Earlier this year, the Shadow Health Secretary Andy Burham gave a speech to the King’s Fund, calling for ‘whole-person care.’

So what do they mean?

At the heart of the concept is planning, foresight and common sense. Rather than a frail, elderly woman slipping on her bathroom floor and breaking her hip, requiring months of expensive hospital care, why doesn’t the NHS modify her bathroom, to help her wash safely, at a fraction of the cost? An accessible shower, or a hand rail, that prevents a trip to hospital, and a long and costly recuperation.

It seems obvious, but as with many things, the simplest ideas can be the most difficult to make happen. It means a council’s adult services department has to work with social services and other relevant departments to ensure the elderly woman has the help and support she needs to be able to stay in her own home, with minimum crisis care. Then there’s the question of the NHS hospital Trusts – should they be contributing to the cost of the handrail, since they will be saving money on patient care?

It’s an idea that think tank the Local Government Information Unit has been discussing for years, but has recently become centre-stage policy for the Conservatives and Labour.

The argument over who pays is where government gets involved. Both the Coalition and the Labour Opposition think some kind of rebalancing of NHS and social care budgets is a step in the right direction. The question is; to what degree?

Labour’s argument goes like this; one person might need to use three healthcare services – the NHS for their physical needs, mental health services on the edge of the NHS, and social care. One person, three services. So why not integrate the three budgets, and provide an NHS for the needs of 21st century?

But the Health Secretary has rejected his Shadow’s proposals for a full merger. He told the Health Service Journal this summer that the coalition would push for integration of budgets without “the upheaval and organisational disruption” of a “massive reorganisation of budgets and structures.”

And that re-organisation is at the heart of the problem. Big change costs big money. Too little change means the status quo prevails. Add an ageing population, and therefore higher social care and NHS bills, and this debate will run and run. Just don’t expect anything radical in the short term.

PLMR is a political lobbying and media relations agency based in Westminster, working with some of the biggest health and social care providers in the UK.