Good ideas cost money

The education white paper may have had Labour MPs in open revolt, but the medicine prescribed in the health and social care white paper should be much easier to swallow. It is hard to imagine anyone taking exception to the four main goals of the white paper published this week, Our Health, Our Care, Our Say: better prevention, more choice, less inequality and more support for people with long-term conditions. 

If the new policy tackles inequality, rather than exacerbates it as its education counterpart threatens to do, that alone will have been a good enough reason for formulating it. More primary care services in deprived communities and improved care for chronic conditions will help to end the scandalous health inequalities which sustain a difference in life expectancies between north and south of as much as 10 years.

Though health secretary Patricia Hewitt could hardly have skated more lightly over social care when she launched the white paper, in reality the broad programme set out in last year’s green paper has found its way into the new document. Power and choice, exercised through a variety of mechanisms such as individual budgets, are still the predominant themes.

The new document rightly recognises the cross-agency leadership role of directors of adult social services in promoting social inclusion and proposes to underpin it with statutory guidance later this year. Equally important, it seeks to “redefine and strengthen” the role of directors of public health in harnessing resources from primary care trusts and local authorities to maximise health and well-being. And few will object to the proposals for more joint health and social care teams to support people with chronic conditions, though the focus only on those with the most complex conditions will ring alarm bells.

Money is as ever the fly in the ointment. At a time when adult social care is busy bailing out hard-up PCTs, the suggestion that an additional 5 per cent of NHS budgets could be earmarked for communities sounds absurd. He claims to be prepared for it, but care services minister Liam Byrne will need to drive a hard bargain indeed at next year’s comprehensive spending review.

Click HERE to view our Special Report on the Health and Social Care White Paper

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