‘Giving public and front-line professionals more say’

Prime Minister Tony Blair explains how the health and social care white paper aims to create more flexible services modelled around the individual needs of the people who use them

I want to start by thanking Community Care readers for the part they played in shaping the proposals we set out this week to improve social care in England – and for the fantastic job you do every day of every week throughout the country.

I hope you can see how instrumental your voices have been in developing the white paper Our Health, Our Care, Our Say.

Its publication is a key moment in creating a health and social care system that will meet the challenges of the new century, respond to the changes in our society including demographic trends and the increasing expectations of customer service from the public.

In doing so, they are part of a wider reform programme that will allow us to accelerate the move into a new era where services are designed around the needs of the people who use them.

This is, of course, largely possible because of improvements we have seen in recent years thanks to the efforts of dedicated staff like yourselves and the increased investment and reform the government has put into health and social care. 

Waiting lists and waiting times in our hospitals are down, helped in part by giving patients more choice and encouraging new providers within the NHS. And we hit our target for achieving support for people at home two years early. Three themes stand out in the white paper.

The first is how we strengthen personal control of care. People want more control over their lives and we must make sure that this extends to their experience of social care. So we will extend direct payments and expand our individual budget pilots. The councils piloting this initiative have been asked to report by summer of 2007 with recommendations on what the rest of the country can learn and how we can speedily ensure everyone has these opportunities.

Second, we have to change the balance of our resources in health and social care by boosting the money available for prevention – using new tools and incentives to tackle health problems earlier.

We need a greater emphasis on prevention and early intervention if we are to continue improving the nation’s health and well-being and meet the public preference for as much treatment at home or near home as possible.

Last week, the Social Exclusion Unit showed how early, low-level intervention for older people can dramatically extend life without disability. 

This year, we begin spending £60m in pilots to tell us just what kind of interventions work – and another £80m for assisted technology projects, which give people the peace of mind that comes from knowing that if something goes wrong, help will be at hand. These projects not only help older people live independently in their own homes, they can give us early warnings of when things are going wrong. 

But when the lessons from our pilots are in, we need to make sure we support new ways of working with the right investment.

That’s why we are clear that meeting these challenges will require a sustained shift in how we use the massive investment we are making in health and social care services. Increasingly we need this money spent on prevention and also marshalled by social care and health professionals who work much closer together.

I don’t want to pre-empt the results of local consultations on new primary care trust borders, but it looks like we will end up with much more coterminosity between social services and health commissioners. 

The white paper takes that joint working beyond simply a shared boundary line. It sets out how the outcomes in the social care green paper will now become the basis for new, shared goals for social care and the NHS, backed by aligned inspection, local area agreements, and a joined-up budget across the health service and local councils. It explains how our new, integrated community facilities, workforce and electronic records will make working together easier.

We will put in place the right incentives for local government and the NHS to work effectively in tandem, and give service users a bigger voice over the care they receive.

All this will encourage local innovation, including the use of new providers where necessary, to meet local needs. We want change to be driven, not centrally, but in each community by the people who use services and by the staff who provide them.

By giving front-line professionals and the public more say and control over services  I am confident that we will continue building a high-quality health and social care system which meets the future needs and wishes of the country.


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