Friday, January 13, 2017

How best to deliver health and social care.

On Wed two things happened at the same time in my life. I read an email from a constituent pleading with me to pressurise the Chanceller to allocate more money to the NHS. At the same time, I was participating in a debate in the House of Commons about 'The Future of A&E services in Shropshire and Mid Wales'. The instigation for this debate was a decision by the two Clinical Commissioning Groups in Shropshire to ignore the recommendations of the Future Fit Programme Board which had been set up by the very same two CCGs to research and recommend a way forward to improve A&E provision. This research had taken three years, and had cost several million pounds. What sort of a waste of money was that - millions of pounds that could (should) have been invested in our NHS. These points may not be earth shattering in themselves, but are typical of what happens on a daily basis.

It's about money. Now I'm not an economist but I can spot a trend that's going off the graph. It's why I snort, almost derisively when opposition politicians shout about 'austerity'. We are already spending like there's no tomorrow. The UK deficit remains unsustainable over the long term. And it's not so much that our  National Debt is reaching heights that would daunt Sergio Bubka, but it's going up and up. And when I talk to those who understand local government pensions, I'm horrified by the level and growth of these extra liabilities. And it seems that consumer and personal debt is reaching record levels as well. It's against this background we need to consider NHS funding.

I do think NHS funding (incorporating social care) will have to receive more funding though. But it will have to be balanced by budget reductions elsewhere. We are living longer, many of us with multiple health problems. There are new expensive health treatments coming along which keep alive patients who would have died until recently. New pressures are piling on clinicians, many of whom are retiring early. No matter how hard they work, it becomes ever more difficult to keep up. There will be more money, but it won't ever be enough. This is why it makes my blood boil to see millions wasted by failure to face up to reality and tough decisions - as we've seen recently in Shropshire.

I know this blog post could run to a hundred pages, so I'll just add one point I'm interested in floating with the Chancellor. We need to help/encourage family care of those who need it, rather than expect the state always to take the full burden. Many families do of course. But too many don't. We need to use the taxation system in an imaginative way. Tax allowances for approved capital spending to help families adapt homes. Better targeted care allowances for domicillary care. The extra money we must invest in our health and social care system should be directed towards ensuring more care is delivered at home and not in hospitals, the purpose of which should be to treat people not who need clinical care rather than social care. And we need to move fast.

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