New Commission launched on the future of health and social care

The King's Fund has launched a new Commission to consider whether the post-war settlement, which established separate systems for health and social care, remains fit for purpose.

Huge social, demographic and technological changes have taken place since the NHS and social care system were established in 1948. With health and social care services facing unprecedented challenges, the Commission will examine the way that entitlements, benefits and funding are currently organised and whether they could be better aligned to meet the needs of 21st -century patients and service users.

The Commission will undertake its work at a time when the NHS is undergoing significant change and with proposals to reform social care currently before Parliament. What sets it apart from other reviews past and present is that it will fundamentally re-examine the terms of the post-war settlement which established the NHS as a universal service, free at the point of use, and social care as a separately funded means-tested service.

The Commission will be chaired by Kate Barker, a former member of the Bank of England's Monetary Policy Committee and now a holder of a number of non-executive posts. Although it has been established by The King's Fund, its reports and recommendations will be produced independently. An interim report will be published early next year and a final report in September 2014, in time to influence thinking ahead of the next General Election.

Chris Ham, Chief Executive of The King's Fund, said: 'The NHS and social care system have remained separate since their inception in 1948. 65 years on, the needs of patients and service users have changed and the world is a very different place. The time has come to return to first principles and ask whether the current arrangements are fit for purpose.'

Kate Barker, Chair of the Commission, said: 'The issues we will be considering go to the very heart of the debate about how best to organise health and social care. I look forward to working with my fellow commissioners to consider whether, and if so how, the current settlement should be re-shaped to meet better the needs of 21st-century patients and service users.'

Notes to editors: 

For further information or to request an interview with Chris Ham, please contact The King's Fund press office on 020 7307 2585 (or 07584 146035 if calling out of hours).

In addition to Kate Barker, the other commissioners are:

  • Geoff Alltimes, chair of the LGA multi-agency task group on health transition and previously Chief Executive of Hammersmith and Fulham Council and NHS Hammersmith and Fulham.
  • Lord Bichard, cross-bench peer and Chair of the Social Care Institute for Excellence.
  • Baroness Greengross, cross-bench peer and Chief Executive of the International Longevity Centre UK.
  • Julian Le Grand, Richard Titmuss Professor of Social Policy at the London School of Economics.

Mark Pearson, Head of Health at the Organisation for Economic Co-operation and Development, will act as the Commission’s international adviser.

The Commission will consider three broad questions:

  • Does the boundary between health and social care need to be redrawn? If so where and how? What other ways of defining health and social care needs could be more relevant/useful?
  • Should the entitlements and criteria used to decide who can access care be aligned? If so, who should be entitled to what and on what grounds?
  • Should health and social care funding be brought together? If so, at what level (i.e. local or national) and in what ways? What is the balance between the individual and the state in funding services?

It will issue a call for evidence, commission research to help inform its thinking and engage with stakeholders to test ideas and options.

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.