Policy Discussions on Health and Social Care

These notes are a summary of points which were raised when Andy Burnham visited Easington and Peterlee on  May 9^th and in the subsequent Policy Forum held on the subject by Easington CLP on May 17^th.  This was led by Grahame Morris M.P. and Councillor Lucy Morris, Cabinet Member for Health at Durham County Council.

 Andy Burnham at the Gateshead Policy Forum.

• The NHS was never set up to deliver the complete model of health as defined by the World Health Organisation.  There are in fact three separate services, the NHS, Mental Health Services and Social Care.  These need to be integrated to deliver “whole person care”.
• We will need to pay more for social care.  The greater prestige of the NHS and the current  funding mechanisms have led to a disinvestment in Social Care.  There is no sense in “ring fencing” the NHS but reducing local authority funding which pays for social care.
• AB proposes that local authorities should commission both health and social care.
• Britain is the only country in the G20 which spends less than 10% of its GDP on health.
• If we extend the NHS philosophy to social care, and have joint commissioning, this will remove perverse incentives to keep people in hospital and not provide good social care.  There is, however, a funding issue.

Questions raised in debate

• Public health is important, to prevent illness in the first place.
• Local Authorities may not want to be the final arbiters of NHS policy such as reconfigurations.
• Overall general support for the basic idea that social and health care should be treated the same.  Mental Health still the “Cinderella”.

Policy Forum in Easington May 17^th

• The present 111 system is not working and causing unsustainable pressures on A&E.
• Proposals to limit what people have to pay for long-term care benefit the better off.
• Proposal is that in order to get free social care no one should lose more than 20% of their estate.
• The NHS and local authorities should be “preferred providers”.  This presents an issue with long-term care and care in the community, most of which has now been privatised.
• There is an issue of loy pay in social care.
• An estate tax might be the best way to pay for social care.
• Problems of different management structures, conditions and accountability between Health and social care.
• In Co Durham the AAPs (Area Action Partnerships) are a good way of drawing down funding for health initiatives.  The “Health Express” from Shildon could be used across the County.
• Healthworks, which is a health resource, works well, and should be extended across the County.
• The PFI model results in high rents, and results in facilities across the area such as Sedgefield and Seaham, not being fully used.
• Health should work closely with housing.
• There needs to be engagement with the public both to listen to their views, and explain health issues to them.

Overall Points for Labour Party Policy Team

• People accept the overall idea of integrating health and social care, but are concerned about the funding plan.  This must be robust before the election.
• Concerns about overall responsibility being with local authorities.  Some may not want, or be able, to make difficult decisions.  Should be a partnership between them and NHS, not one in charge of the other.
• Danger mental health continues to be neglected.  Need for preventative mental health strategies, such as social proscribing, use of leisure facilities, such as “men and sheds”.
• Healthworks model of a health resource which local people can use should be extended.  This is something local people have control over, and encourages them to find healthy solutions, rather than be lectured from in high.
• Community bodies, such as Area Action Partnerships, should be encouraged to work with the NHS and draw down funds for health projects.
• Hospital funding system a “perverse incentive” to keep people in hospital.

David Taylor-Gooby

Political Education officer, Easington CLP.