Long-term sustainability of social care under threat, MPs warn

The Select Committee on the Long-term Sustainability of the NHS has published a report criticising the 'short sightedness' of successive governments for failing to plan effectively for the long-term future of the health service and adult social care.

Lord Patel, chairman of the committee, warned that the Department of Health was failing to think beyond the next few years at both a political and official level. The report outlined a lack of long-term strategic planning in the NHS and blamed politicians for implementing short-term fixes as opposed to long-term solutions.  

Patel recommended: “To solve this we need a new body that is independent of government and is able to identify clearly the healthcare needs of a changing and ageing population and the staffing and funding the NHS will require to meet those needs. This new Office for Health and Care Sustainability should be a trusted, independent voice as the Office for Budget Responsibility has become on economic forecasting and on public finance matters. It will need to look ahead and plan for 15-20 years into the future. 

"We also need to recognise the NHS will need more money. NHS spending will need to rise at least as fast as GDP for 10 years after 2020. One area where more spending will be required is on pay for lower paid staff. We are in an increasingly competitive international market for health professionals and a decade of pay constraint in the NHS has damaged morale and made it difficult to train and recruit the staff we need. 

"We have heard much about the need to integrate health and social care and we think the best way to do that is make the Department of Health responsible for both health and adult social care budgets. We also think it is time to look at the way care is delivered. This may well involve changing the model where GPs are self-employed small businesses.  Delivering health care fit for the 21st century requires improvement in primary care to relieve pressure on hospitals. That change should be delivered by GPs."  

Meanwhile, councillor Linda Thomas, vice chair of the LGA's Community Wellbeing Board, added: "Securing the long-term sustainability of adult social care is vital. Adult social care is critical to the health and wellbeing of people with a complex range of often intense needs, their carers and families, and our communities more generally. An adequately funded social care and support system is essential for supporting the sustainability of the NHS by reducing the demand it faces. Equally, what the NHS does or does not do can have an important impact for social care; reductions in services such as incontinence treatment, stroke rehabilitation and NHS continuing care increase pressure on adult social care. Without investment in primary, community and social care services we will continue to wrongly focus on where pressures present, rather than tackling them at their source.

"The announcement of £2 billion for adult social care in the Budget marks a significant step towards protecting the services caring for older and disabled people in our communities over the next few years. However, this is a short-term measure that does not address all short-term pressures and it gets us no closer to a long-term solution to tackling the funding crisis to help provide care and support for people to enable them to live more independent, fulfilled lives.

"The government's commitment in this year's Budget to publish a Green Paper which explores options for a long-term solution to reform and fully fund our care system is a key opportunity to establish how, as a society, we should best support people of all ages with care and support needs in our communities both now and in the future.

"For the Green Paper to be successful, local government leaders must play a central role so that any solutions are workable, affordable, and support the spirit and letter of the Care Act, which councils are fully committed to.

"Councils, working with their local partners, must have full flexibility over how they use this funding to ensure it is directed to where it is most needed and so that it helps people live independently in their communities and surrounded by their families and friends."

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