Social care directors have demanded a debate on whether health services delivered alongside social care should be subject to charging.
The Association of Directors of Adult Social Services and Association of Directors of Children’s Services said the government’s drive to integrate health and social care would make it increasingly difficult to explain to users why NHS services were free and social care was not.
In its response to the Department of Health’s commissioning framework on health and well-being, consultation on which closed last week, the associations said: “Having to contribute to the cost of one part of a joined-up service and not another makes no sense to the public.”
They said the issue would become increasingly prominent owing to the growing number of service users who purchase their own care through direct payments and individual budgets.
The commissioning framework is designed to help councils and primary care trusts deliver last year’s care services white paper, which called for more user empowerment, the integration of health and adult social care, and a shift from acute to preventive services.
In a separate response, the Inter Agency Group on adult social care, which includes Adass, the Local Government Association and charities including Age Concern and Mencap, raised doubts about DH estimates that the framework would cost £17m to deliver and yield £52m to £4.6bn in efficiency savings, citing a number of potential costs.
These included the need to build commissioning capacity in councils and PCTs, and to monitor the effectiveness of preventive care.