WHOLE PERSON CARE IS ESSENTIAL

YESTERDAY Labour’s Shadow Health Secretary Andy Burnham set out how Labour would deliver better health and care in an era when money remains tight. This is in contrast to the Tory-led Government’s decision to spend billions on an unnecessary top-down re-organisation of the NHS and cut thousands of nursing posts.


Labour’s vision is an NHS committed to ‘whole-person care’, bringing together physical health, mental health and social care into a single service to meet our care needs.

There is a huge sustainability challenge in an era where there’s less money around. But the Tories and their Lib Dem allies are choosing to spend billions on an unnecessary and damaging top-down re-organisation of the NHS.

There are now 3 million people over 80 and this will nearly double by 2030. But under the Tories we are seeing the social care system collapsing, with rising charges for families and an ever-greater burden on the NHS.

There are also increasing numbers of people with complex needs, mental health problems, or long-term conditions. Conditions, such as diabetes and asthma, are set to rise from 15 million today to 18 million by 2025. But the Tories’ marketisation is fragmenting care, not integrating it.

At the moment, we have 3 fragmented systems dealing with different aspects of health & care: physical health in acute hospitals; mental health often in separate services on the fringes of the NHS; and social care in council-run services.

This has two big problems.

Firstly it’s a system that works for Whitehall, but not for people.

Older people being passed from pillar to post by different professionals and different points of contact. People in hospitals or A&E with mental health problems find themselves in a system that is only treating their knee or their liver. A quarter of all patients admitted to hospital with a physical illness also have a mental health condition that, in most cases, is not treated while the patient is in hospital. Furthermore, people with mental health problems often find their physical health neglected. Those with serious mental health problems die on average 15 years earlier than everyone else.

Secondly, it’s wasting billions and we end up paying for failure.

People with physical illnesses can find themselves struggling with undiagnosed mental health problems. Untreated mental illness costs the NHS around £10 billion each year. When care services are cut by local authorities the NHS ends up picking up the pieces – even though it is far more expensive to treat someone in hospital.

I’ve always believed that rather than paying for failure, with payments for people coming through the hospital door, it would be better to prevent them needing hospital treatment in the first place

Where local council care services are inadequate, people can’t be discharged from hospital because when help is not there at home. This is costing the NHS £4 million a week.

That is why I am delighted that Andy Burnham has set out Labour’s alternative solution – ‘whole-person care’. This is a radical shift to bring our health & care services into the 21st Century. Instead of three separate services treating different bits of a person, Andy is proposing a single service to meet a person’s care needs.

This will have real benefits compared to the Tories’ plans for increased fragmentation, which include:

1. not paying for failure, but preventing people becoming ill and keeping them out of hospital.

2. not dismantling the NHS but joining up services to create a single point of contact to coordinate all your care needs.

3. more care provided in people’s own home – offering more choice & control about how and where people are treated.

4. giving mental health as much priority as physical health.

5. new rights in the NHS constitution, providing clear national entitlements for care, ending the postcode lottery, and the right to therapies for mental health problems.

This means the full integration of health and social care, as well as breaking down the barriers between physical and mental health services. Some of the ideas that Labour want to consult on are...

• A single pooled budget – combining the £104bn budget for health and the £15bn budget for social care into a single £119bn budget [illustrative figures for the year 2011/12].

• NHS professionals like GPs, doctors and nurses to play a greater role in coordinating the provision of social care services, and joining them up with other health services.

• More joined-up commissioning of health and care services at local level, with NHS and local-authority commissioners working in partnership.

• A ‘year-of-care’ payment system for those with long-term or complex needs (to replace the current Payment by Results tariff), shifting the incentive to prevention rather than just treatment when things have gone wrong.

This is a perfect illustration of the ‘One Nation’ policy prospectus that Ed Miliband launched in his conference speech last year. In the next two years Labour intends to develop and explain that there is an alternative progressive approach to the politics of austerity and despair being offered by the Conservatives and their Liberal democrat collaborators.