Independent commission will look at split between health and social care in EnglandBMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3973 (Published 19 June 2013) Cite this as: BMJ 2013;346:f3973
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The Labour party has shown its hand detailing an alternative to the coalitions health care agenda. This is in light of the party's recent consultative policy review.
Labour has announced that it believes that Clinical Commissioning Groups' budgets could be managed by local councillors instead. Labour argues that the merger of health, social care and mental health budgets would de-fragment the NHS, ergo, giving people better results. They see it as whole person care.
This philosophy is not too unreasonable. Jeremy Hunt recently declared a return to family doctoring: GPs were to be responsible for their patients' care out of practice hours. For Labour, the GPs on the commissioning groups could be released to deal more directly with patient requests at home.
The population is ageing, and so the need to incorporate all aspects of clinical and non-clinical care is growing. Locally elected councillors, by virtue of a political term, have to answer directly to the public. If they're not up to scratch, then they're given the boot. As representatives of the people, they can spend their time giving the government an earful when things aren't working well. Some commissioning groups have already been having difficulties with local hospital department closures instigated by central government diktat that went over their heads.
People question whether this could be avoided under Labour's proposals.
If Labour is elected in 2015, the successful implementation of the its ideas will be complex and drawn out. Will commissioning groups be content acting as advisory boards instead of making the decisions? Some people would say that they don't think there is anybody better placed to target NHS resources than those who see real patients with real diseases in real adversity every working day. They question whether the humanity might be lost on local councillors who haven't sat in a GP's surgery and listened to patients.
What is obvious is that if the pooling of the £104bn NHS budget with the £15bn social care budget were to take place, elections would truly be centred on healthcare provision. The increased risk of further political meddling with our national treasure, as a result of this, is pertinent. The BMA, the trade union and professional body for doctors, called a vote of no confidence in the health secretary. Mistrust about the management of healthcare in this country is already dangerously high.
Any further political interference in how healthcare is provided would make it an even greater political hot potato that might negatively affect the ability of practitioners to discharge their duties in the future.
This puts into question whether or not there is a better way to integrate health and social care that is at arms length of both locally elected decision makers and the clinicians themselves.
Competing interests: No competing interests