Council cuts will damage social care, warn doctors’ leaders

Government plans for closer working between health and social care could be damaged because of savage cuts to local council budgets, doctors’ leaders warned today.

In its response to the health White Paper, the British Medical Association warned that local authority funded care will be affected by budget cuts making it more difficult to commission integrated care pathways and services.

It said that for such plans to work local authorities needed to be properly funded and appropriate services needed to be in place.

Moreover, the policy of promoting competition through an “any willing provider” policy would make it impossible to achieve the goal of integrated care pathways.

Dr Hamish Meldrum, chairman of council at the BMA, said: “Doctors want to build on the founding principles of the NHS, and to maintain and improve services despite the hugely challenging financial climate.

“However, they can only succeed if they can work in partnership with others in a co-operative environment.”

Its views mirror the fears of local council leaders and the NHS Confederation on the effects of the cuts on current and future joint working arrangements.

The health White Paper, which was published in July, unveiled plans to give GP-led consortia control over much of the budget, while at the same time scrapping primary care trusts and strategic health authorities by 2013.

Councils would take on PCTs’ public health functions and be charged with leading the integration of health and social care locally.

The BMA backed better joint working and urged the government to provide a clear definition of adult social care in its forthcoming vision to help better joint commissioning.

It added it did not support an insurance model as the basis of future care funding arrangements, which is under consideration by the commission on the funding of long-term care and support.

A voluntary insurance scheme is backed by the Tories, though the BMA has said it favours a “partnership model of state and individual funding”.

The BMA pointed out that GP-led consortia will not be able to function if they are expected to pick up all the current statutory functions and responsibilities of PCTs.

Such roles include child protection and will still have to be carried out after PCTs are abolished.

The BMA said it supported aspects of the proposed reforms outlined in the paper, such as devolving more control to patients and frontline clinicians, and a stronger focus on public health as well as increasing local democracy in health.

However it had concerns about extending choice of treatment and provider to mental health services, without such an offer being piloted and evaluated.

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