Labour

We need swift integration of care to safeguard the future of our NHS - Miliband

On a visit to Lancashire today, Ed Miliband called for the swift integration of health and care services so that the NHS can be made financially sustainable and provide a better service for the future.

He cited figures from the Nuffield Trust which show, unless we improve the way services are delivered, growing care needs will leave a shortfall of up to £29 billion a year by 2020 in NHS funding.

And he highlighted evidence from recent surveys showing NHS leaders believe David Cameron’s top-down NHS reorganisation, reforms which were not needed and no-one voted for, is stifling the real change the health service needs. Not only is this resulting in thousands of nurses being laid off, A&Es in crisis and treatments being rationed, it is also putting the financial sustainability of our NHS at risk.

Mr Miliband announced the launch of an Independent Commission which is being asked to find ways of integrating health and social care for the next Labour government so that both of these key public services are affordable in an era when there is less money around than there was in the past.

Ed Miliband MP said:

“The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.

“The NHS will always be a priority for expenditure under a Labour government but we must make every pound we spend go further at a time when our NHS faces the risk of being overwhelmed by a crisis in funding because of care needs by the end of this decade.

“When the NHS was in crisis in the 1990s, Labour was able to save it by combining reform with unprecedented increases in funding. We know that budgets will be tighter under the next Labour government. But even in these tough times we want the NHS to provide a better service for patients.

“The changes we propose will ensure that - but they do something else too. They will save billions of pounds which can be better spent elsewhere in the NHS. These reforms are necessary if we are going to ensure that the high quality effective NHS, which the British people expect, is affordable in the decades to come.”

He described how the growing number of older people and those with chronic illnesses is fundamentally challenging current models of care, where different problems are handled separately in different services. Instead, he argued that the future demands ‘whole-person care’ – an agenda that would bring together physical health, mental health and social care into a single service to meet all of a person’s care needs. By ensuring the commissioning of health and care services at local level are joined up better, both services can be planned more effectively and affordably.

He said:

“In the 21st Century, the challenge is to organise services around the needs of patients, rather than patients around the needs of services. That means teams of doctors, nurses, social workers and therapists all working together. It means care being arranged by a single person who you know – ending the frustration of families being passed around between different organisations and having to repeat the same information over and over again. It means a greater focus on preventing people getting ill and more care being provided directly in people’s homes so they avoid unnecessary hospital visits.”

He highlighted evidence showing that many NHS leaders believe the Government’s reorganisation is damaging and delaying the integration of care.

He said:

“There is widespread support within the NHS and care services for integrating care. But, for the last three years, the Government has turned the NHS upside down with a top-down reorganisation that has virtually nothing to do with the urgent challenges we face of improving the way care is delivered. It has wasted £3bn re-arranging management structures while nurses are losing their jobs, A&Es are in crisis, and treatments are being rationed. Attempts to integrate care are being harmed by David Cameron’s push to turn the NHS into a full-blown market.

“We have a different vision for the future of our NHS - one which embraces its founding principles of co-operation and integration rather than imposing fragmentation and free market ideology.

“Bringing about the change we need means listening carefully to all those who work in, and rely upon, the NHS. The Commission I am announcing today will look at different ways of bringing the health and social care budgets together so we can build consensus on how together we can secure the NHS for our children’s generation. Labour created the NHS after 1945. New Labour rescued the NHS after 1997. One Nation Labour will renew it for the 21st Century.”

Ed Miliband was joined on the visit by Labour’s Shadow Health Secretary, Andy Burnham, and Shadow Minister for Older People, Liz Kendall.

Andy Burnham MP said:

“The Government is taking the NHS down the wrong path. Ministers have put it on a fast-track to fragmentation when the future demands integration. They want more competition, setting hospital against hospital, when it is collaboration that will bring the greatest gains.

“NHS staff are feeling battered and bruised. They can see everything they care about being washed away in this dash to privatisation and patients paying the price. Labour wants to give them hope by building a genuine alternative based on the values they share: public service and people before profits.

“Whole Person Care is a vision for a 21st century health and care service. By uniting social care with physical and mental, it builds a single service that can deal with all of one person's needs. It updates and extends the vision of the post-war Labour Government and makes it ready for the challenges of the century of the ageing society.”

Liz Kendall MP said:

“Too often patients and their families struggle with all the different NHS and social care services to get the help they desperately need. This isn't good for them, and it wastes taxpayers’ money too.

“People want services and support that fits round their lives, helping them to stay in their own homes wherever possible. And the state of the public finances demands that our care system does far more to prevent people from having to use more expensive hospital services and residential homes when they don't need to.

“That’s what Labour's whole person care agenda is all about.”

The visit marked the launch of Labour’s Independent Commission on Whole-Person Care, led by respected international expert and former Department of Health specialist Sir John Oldham OBE. The Commission will produce recommendations on achieving Labour's vision of ‘whole-person care’, without another top-down reorganisation and within existing resources.

Sir John Oldham said:

“I am very pleased to undertake this important task. 70% of activity and cost in the care system is for people with multiple chronic diseases, which includes a rising number of older people. Their care crosses organisational boundaries, and is fragmented. Those patients say: I want you to treat the whole of me, and act as one team, which also leads to better outcomes and greater efficiency for the whole system. We need to bring that about.

“If we don’t change, the crisis of need approaching rapidly will make the NHS and care system unsustainable, and reduce the competitiveness of our economy driving a spiral of decline. It is that significant.”