Illustrated summary of the Barker Commission's final report

The final report from the independent Commission on the Future of Health and Social Care in England examines the current health and social care systems and proposes a new approach that redesigns care around individual needs. The commission has concluded that this vision for a health and care system fit for the 21st century is affordable and sustainable if a phased approach is taken and hard choices are taken about taxation.

What do you think?

  • About the new settlement the commission is proposing?
  • How it could be achieved?
  • How it should be paid for?

Tweet using #barkercomm or comment on Chris Ham's blog, Now is the time to create a combined health and social care system.

This is an abridged version of the final report. Download the full version, including all 12 recommendations, here:

Download from SlideShare

Comments

#42548 J erasmus

My farther has a small private pension which he pays tax on after all bills have been payed he has less than 100 to buy food etc he can not get any help on rent rates because of his health even if cost of priscription he would be unable to afford this becUse of previous job I am aware that some of people on pension top up as they pay no rent rates are able to go on at least 2 holidays a year these are people who did not put into pension funds

#42560 Alanius

I am 74 and have two private pensions which I paid into for when I retire. I get a reduced state pension because I was in the RAF for fifteen years therefore did not meet the criterion for a full state pension. I pay over £1,000 a year in tax and £143.00 a month council tax. As I made provision for my retirement why should I be asked to pay more for my health care. I was healthy all my working life of 50 years and was diagnosed with Rheumatoid Arthritis in 2007. It is unlikely I will live until 100. It is a fact that as one gets older the body starts to fail, this will happen to the majority of people.

#42609 MikeJM

I think that many of us paid Income Tax & National Insurance for many years & just see it go into "one big pot" that is spent on a myriad of things and there is a perceived disconnect between what we pay and what we receive. The demarcation between NHS Care & Social Care is such an example.

I like the principle that money raised by National Insurance (NI) is regarded as Insurance and is spent on health & care services, unemployment & pension benefits. if we need more for these (in my opinion, essential) services then we increase NI contributions. However, these contributions need to be "ring-fenced" for these activities and not spent on other items or disappear into general government expenditure (including Defence, Foreign Aid, etc.)

As we aware that we could benefit from these NI contributions in the future, we would probably be more willing to pay them and they could be levied across the whole income spectrum, say as 12% of all sources of income. Avoidance should be minimised and no exemptions permitted - 12% at £25,000 pa and 12% at £250,000 pa and 12% on dividends, 12% on capital gains, 12% on selling your house (even the primary residence).

Eventually we will realise what we need & where it is spent, perceive the benefits and find that we can raise the money at say 10% or ....

#42619 edward Plumridge

If we scrapped 'the internal market' which was set up to privatise NHS services there would be a saving of £10,000,000,000 (ten billion pounds) or more according to some informed sources and the health professionals would all give a sigh of relief as the process is cumbersome wasteful and unproductive

#42622 Jon Morris

I agree that there is a need to bring social and medical care for the elderly together. However this needs to be done at a local not a national or regional scale. Patients are individuals they therefore need to be treated with a flexible and holistic response. Very large orgnaisations always seek to control and define a narrow range of "best value" responses. Thus patients get treated as a series of seperate problems, by a number of "experts" none of whom deal with the whole person. The experts are then expected to meet specific targets further disatancing them from actual care for the person.

Demnark decentralised its health service to put it mainly under local authoirty control with (according to various international bodies ) huge success. We should see waht we can learn from them. But it has to be real decentalisation not an NHS or central government seeking to retain control while in reality just dumping blame.

#43575 Terry

I find after years and years of discussion and reports, their repetative findings incredibly embarrassing to read. When I think of all the professionals and experts in the field that are simply incapable of ensuring radical change where it matters, on the ground, it becomes a real worry.
As a member of the public I find such endless findings, good as they may be, cast a very big shadow on the ability of managers and policy makers to actually manage the problem and importantly to 'bite the bullet' whilst all the while the public are suffering as this farce is endlessly rolled out.

#43625 Yvonne Adams

Having become disabled at 42 and given a company pension on medical grounds I have to pay for my means tested social care support as well as the preventative health care I need such as regular physiotherapy. The NHS is unwilling to pay for my physiotherapy because my conditions are "chronic". Consequently my husband has had to give up work to support me. Our financial "choices" are dominated by paying for the support and therapy I need!! I am only 55 now, so roll on the Care Act funding cap and a more integrated health and social care system.

#43920 Abdul Jaleel

As a retired NHS Consultant, I can recall numerous occasions when I saw the throw-away culture permitted staff to discard re-usable materials to be wasteful and occasionally damn negligent [they wouldn't this at home ].

I recently met the Chairman of hospital Trust in England where I worked for over 20 years and mentioned that people in his domain were leaving ALL lights on in the corridors and mini-nightingale wards for hours in summer day light even in these days of austerity , to which he shrugged his shoulders and said, "one cannot micromanage in the NHS "!

#46073 Susan Lomax

Mum was first diagnosed with dementia and so had to pay for all her care until all her hard won savings were gone. Then she was diagnosed with pancreatic cancer, for which all her care would have been paid. She didn't live long enough to benefit from that. Where is the logic? An illness is an illness, whether it's mental or physical. Dementia is a terminal illness and there is no cure. We need to support those affected, especially as a dementia " tsunami" is fast approaching.

#46607 mike lewis

stop sending money abroad to third word countries run by corrupt governments and start spending the money looking after our own people that have paid into the system all their life.

#47955 Beverley Taylor

This is the most sensible report I have read on health and social care for a long time.

I just worry about the implications for the viability of local government and local democracy when adult social care is given to health. What will be left for local government? It shouldn't stop the joining up health and care which is most needed, but it will have big implications for the future of local authorities.

#48315 Tom

Reducing the £5 billion in fraud by NHS employees and patients each year would go a long way to paying for these changes rather than increasing taxes.

#57747 Liam Hughes

Dementia is a neurological disease with profound medical and social repercussions. The costs of healthcare and social care for people with this condition should be met out of general taxation/ NI (as it is for many other conditions). We should reject any approaches which imply that services for people needing continuing health and social care are less important. Getting this right is an important mark of a civilised society.

#72088 Vimala Saraswathi

If some of the regulation on disposing the unused medication and all other things, is to be taken off. Let professionals use their common sense what to be disposed of what not to be, which can save a huge amount of money.
Not to give any aid to those countries where money is misused and fill the pockets of corrupt politician.
Try understand each other, wash away the Blame and Claim culture.

#178121 Louise Irvine
GP
National Health Action Party

Where is your evidence of £5 billion of NHS fraud? If you are referring to the recent "report" about NHS fraud it was thoroughly discredited.

#178167 Louise Irvine
GP
National Health Action Party

This is an excellent report in many ways. Its main recommendation - that personal social care be free and integrated with health care is good. Trying to work out what is health care and what is social care leads to a bureaucratic, time consuming process with illogical,, insensitive, inconsistent and often inhumane results that cause distress and delay for thousands of people needing care. Where I disagree with the report is the proposition that the money should be raised by means other than general taxation. General taxation is the most cost effective, progressive and easy to implement system for raising funding for public services. It does not make sense to me to say that older people who will be the main beneficiaries should pay more, because all of us (or most of us) will be old one day so we will all potentially benefit. The principle of general taxation funding is that there is pooling of resources and allocation to those most in need, when in need, with the wealthiest paying more. What's wrong with that? I would argue that we should not wait til 2025 to introduce free personal social care for those with even moderate needs. We should introduce that as soon as possible as, in the long run, it will save money by helping people remain independent for longer. And it would remove a significant layer of bureaucracy and facilitate joint commissioning as there would be no more time wasted on working out (or arguing about) who should pay for what bits.

#189462 Andy Ross
Economist
High Oak

Mike, cutting overseas aid is small beer and would end up costing us much more in disease control, emergency relief, refugees, defence, exports, lost influence etc

The Barker Report is a very sensible response with very sound economics, but I also believe there is a role for competition, though private sector should be used only as a bell weather

#544316 Cate Brunton-Green
Retired CHD Network Manager
NHS

You are SO right Mike Lewis. Care within our own Country should be the first priority.

#545929 Dora Andrea Orn...
Self employed
Nao Support services for people

NHS waste is at its peak !
Staff and Providers / Commissioners of Services need to be held accountable
For waste and implement Good Practise based on Home Economics ( how they run their household !!
Consultants acquired personal wealth
And involvement in procurement of services via NHS needs rigorous assessment ..
I can write a whole chapter on waste for
Prescriptions not needed or repeated that are sent overseas for people that no longer live in the country ..
Pharmacists need to be held accountable
For every delivery they make etc ..
NHS can save billions on pounds via small changes and consideration of the products and services they use !!

#546082 uk national
administrator

any NI added to elderly should only be applied in steps after the earning threshold required to pay tax to pay tax. Any earning less than the tax threshold is not likely to have 12% available for NI after meeting bills etc.

There has been a lot of jealously about the retired receiving a free tv licence although of the 10 million retired, less than half a million are over the qualifying age of 75 years.

Regarding the winter fuel, I made two small changes and reduced my outgoings by £30 per month - more per year than the fuel allowance and something all ages, especially low income, would benefit from.

Education about healthcare, balance of fresh foods and budgeting should start at schools.

With regard to pensioner benefits who pay VAT, council tax and many, income tax, they would have worked and paid in to NI for 30-50 years. Consider those who have not yet done that many years and those under working age who have still to make a contribution but what they are receiving instead: dedicated maternity wards, midwives, pre and anti natal clinics, child support allowance, vouchers, a free baby pack upon arrival, play areas, leisure centres, sports fields and pools, reduced bus fare, reduced train fares, reduced air fares, tax free clothing, tax free books etc, 25p paid in to savings for any £1 saved by the saver to name but a few. The last point is good, however, remember that a pensioners savings have had their interest rate reduced from 8% per year several years ago to less than 0.5% now. A family with two children are paying less per head in council tax than a retired couple and using more of the services. It is not likely that any retired person would think the country is wrong to support able bodied people not working or working, working age people who cannot and also children, however, it would be misleading for me to say in this comment that the elderly have not and do not contribute or are getting any more financial benefits than anyone else.

#546083 UK NATIONAL
administrator

you are right - supporting another person receiving medical care, a prescription for senakot is £7.50 whereas you can get it in any supermarket for £1.00. Same too with other over the counter products- the NHS would be paying far less than that but the profit is not being fed back in to the system to improve care.

There is no doubt that the medical people do an excellent job but they should look to modernise their approach to the running of it making better use of technology instead of trying to apply different ways to try to get the patient who is vulnerable to pay additional cash sums directly or indirectly.

Add new comment