A new settlement for health and social care

Final report
Comments: 9

This is the final report from the independent Commission on the Future of Health and Social Care in England. In it, the commission discusses the need for a new settlement for health and social care to provide a simpler pathway through the current maze of entitlements. The commission, chaired by Kate Barker, proposes a new approach that redesigns care around individual needs regardless of diagnosis, with a graduated increase in support as needs rise, particularly towards the end of life. 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.

Key findings

  • The commission recommends moving to a single, ring-fenced budget for the NHS and social care, with a single commissioner for local services.
  • A new care and support allowance, suggested by the commission, would offer choice and control to people with low to moderate needs while at the highest levels of need the battlelines between who pays for care – the NHS or the local authority – will be removed.
  • Individuals and their carers would benefit from a much simpler path through the whole system of health and social care that is designed to reflect changing levels of need.
  • The commission also recommends a focus on more equal support for equal need, which in the long term means making much more social care free at the point of use.
  • The commission largely rejects new NHS charges and private insurance options in favour of public funding.

Policy implications

  • Proposals for a single, ring-fenced budget and single local commissioner will have major implications for central and local government and the NHS.
  • Public spending on health and social care is likely to reach between 11 per cent and 12 per cent of GDP by 2025, the next government needs to consider how to respond to these spending pressures.
  • The commission proposes funding changes, including changes to National Insurance contributions, to meet the additional  £5 billion that would be required to improve social care entitlements.
  • A comprehensive review of various forms of wealth taxation needs to be undertaken with a view to generating additional resources that will be needed for health and social care in future years.
A new settlement for health and social care

Print copy: £10.00 | Buy

No. of pages: 60

ISBN: 978 1 909029 35 4

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#42531 Michael Pudaloff
Represent family

My 91year old father with dementia and cancer was denied NHS Continuing care and nursing bed on the grounds he was predictably unpredictable . For almost a month NHS/local authority argued over the cost of a nursing bed. My father never got his nursing bed he fell unsupervised and died 3 days later.

#42549 Terence Kearey

When 23,500 is reached the state steps in.

There should be a maximum five year cap on residential care payments

#42603 C Andrews

So recommendation 10 suggestes that those who have been ambitious and done well for themselves should now pay another 3% on their NI to be told later on in life, when means tested, that they are not eligible.....for anything! So what exactly will I be paying for apart from possible reduced prescription?

Recommendation 8 lets take away the possible one source of contact with the outside world i.e the telly and while you are staying at the 4 walls feel free to add another cardi as you sit freezing your assets off........ REALLY!!

#42969 Maureen Cunningham
Referrals Administrator
NHS Mental Health

It sounds fine but has bee said all before.

#44066 Richard Ogden

I very much doubt any political party would have the courage of their convictions to fully implement the processes required to remedy the health-care system which, to-date, is failing. It would cost too many votes from the electorate.

#54905 Mr V. P. Cooppen
Managing Director
Spencer House Car e Home For Older People

I would like to see a review on how Care Homes are being funded, especially in Kent where the fees are very low. Residents coming to care home are no longer the same, they are very frail, highly and some are totally dependent on others and require two staff to handle them, but we still getting the ceiling price for their care. We need to have a fair system to enable us to provide a high standard of care to comply with all CQC requirements and what is expecting from us. The cost of running a Home in Kent is no different to other areas. Why are we getting a low fee of which does cover the cost of running the Home efficiently.

#276932 deb piper
carers support worker
southern health

I would like to have a voice for the carers of an adult aged 18-65 with a severe and endring menatl health problem. Where i work the other 2 carer support workers have left and southampton city council are not replacing them. This leaves the carers alone and desperate with no support at all.

#543488 Joan Smith
Caring for my husband John at home!!!

My husband needs have not changed yet care has been taken away from him. I disagree that it is fine!!!!!

#544946 g pepper pig
g e g w

Too many people doing hard work in nhs for little thanks or reward. To many managers in my opinion. NHS should not be used by political parties its too important. From experience I've seen how money can be saved through better procurement etc. too much red tape. Patient care sometimes seems like an afterthought. From my point of view the whole problem these days is nit being tackled from the right angle. Care first see what the cost not sure why it doesn't work like this now. Even I with my (mental illness) could see this.

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