Linda Jones, Petersfield County Councillor and Labour lead member on the County Council Adults committee and Health committee, continues her occasional series about health and social care issues, writing for us about the Tory government’s latest proposals for reform.
The recently published government White Paper on health and social care (of February 2021) claims to be delivering ‘joined up care for everyone’ and ending NHS ‘transactional bureaucracy’. It creates a statutory basis for NHS-led ‘Integrated Care Systems’ (ICSs), which bring together NHS, local government and partner bodies, to each serve populations of between one and three million people across England. It restores ministerial powers removed in the 2012 Act.
But will the White Paper measures really integrate health and social care? Isn’t it more about regaining central political control over the irritatingly demanding NHS? Or about saving money by floating off integrated care systems and allowing them to sink or swim alone? Could ICSs actually be a route to attract private companies into and then gradually dismantle the NHS?
All these scary ends seem possible but one certainty is that the Tory leadership now wants more power to set the agenda and intervene in local decision-making. Launching a badly planned restructure during a pandemic is risky but the Tories want to offload much of that risk onto the ICSs to cope with.
Shockingly for a report ostensibly about ‘joined up care’, the dire financial state of care and local authority finances is not worth a mention. Issues around COVID-19, growing health inequalities, CCG (clinical commissioning group) deficits, NHS recruitment, retention and morale are also ignored.
Once again – as in past Tory restructuring disasters – back-of-the-envelope legislation is seen as a magic bullet.