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Sajid Javid working on radical plan to merge social care with health in England

Sajid Javid

Sajid Javid working on radical plan to merge social care with health in England

Sajid Javid plans for a new national care service under which health and social care would be delivered by the same organisation are being actively considered by the government for inclusion in a white paper next month, according to senior Conservatives and Whitehall sources.

The idea of local authorities and the NHS taking joint responsibility for social care, perhaps working from a single combined budget for the first time, would amount to one of the most far-reaching reforms since the NHS was founded in 1948.

At present, local authorities have responsibility for running social care services in their own areas. Critics say there is, as a result, insufficient incentive for cash-strapped councils to develop better care for people in their homes or in the community, as it is cheaper for them if those in need go into hospital where the cost is met from the separate NHS budget.

The result is that many people who could be cared for at home or in the community end up occupying much-needed hospital beds.

Similar systems operate in Wales and Northern Ireland, although there are variations in how much care is paid for by the state. The Scottish government is holding a consultation, due to end next month, on proposals for a National Care Service.

It is believed that health secretary Sajid Javid is examining how a new integrated service that would deliver better care and free up NHS beds across England could be delivered. It is understood there would be national standards for care, and conditions for carers.

The Observer has been told that prime minister Boris Johnson was keen to announce plans to integrate health and social care services last month when he revealed that National Insurance contributions would rise by 1.25 percentage points from next April, to raise £12bn a year for the NHS and social care. But at that time Downing Street remained unclear about how an integrated system could best work, so an announcement was put back.

Under the most radical option of all, local authorities would be stripped of any involvement for social care, which would come entirely under the NHS. Sources say, however, that this would involve too great an upheaval and prove hugely unpopular with councils, many of which are Tory controlled. Councils have already lost much of their responsibility over education.

Last night Tory MP and former health under-secretary Dr Dan Poulter, who works part time as an NHS psychiatrist, said: “There is a growing expectation that a substantive health and social care white paper will emerge in the next few weeks aiming to establish a national care service.

“If integration is to be a success, it is essential that reform does not just deliver parallel commissioning of health and care services but also services commissioned through a single pooled budget. Unified health and social care budgets are the only way to deliver both a more efficient health and social care system as well as properly joining up for the benefit of patients what is currently a badly fragmented system.”

Former Tory Cabinet Minister Damian Green, who has written extensively about social care added: “Running social care jointly between local authorities and the NHS would be an interesting idea but would of course still leave big questions about how you attract a bigger and better paid workforce, how you ensure appropriate housing so that people do not go prematurely into residential care.”

In his party conference speech last week, Johnson hinted at integration. He said: “In 1948, this country created the National Health Service but kept social care local. And though that made sense, in many ways generations of older people have found themselves lost in the gap.” He added it was not just about providing more money but reforming the system. “This government that got Brexit done, that is getting the vaccine rollout done is going to get social care done.”

The Covid-19 pandemic brought the social care crisis even more sharply into focus. Currently a shortage of about 120,000 care workers means 300,000 people are waiting for local authorities to assess their needs or provide care. In addition, many elderly people who end up in hospital because of poor local provision of care cannot free up beds once they are better because there are no places in residential care homes.

There are about 17,000 homes in England, most run as independent small businesses funded by local authorities or paying residents, making coordination with the large hospital trusts difficult.

Shadow health secretary Jonathan Ashworth said: “Social care is in desperate need of wholesale reform but the cap Boris Johnson announced fails to provide the fix he promised. It’s vital care and health services are brought closer together to provide personalised care so people can stay at home and not be forced into a home.

“That’s why I’ve long advocated national care services, locally delivered within national standards, to provide the quality care people deserve.”

Sally Warren, director of policy at the King’s Fund, said: “In reality, people mean different things when they talk about bringing social care into the NHS. For some it means having social care services delivered by the NHS. For others, it means some shared accountability for how health and care services work together. Rather than spending energy shuffling responsibilities from local government to the NHS or vice versa, the important thing is to focus on improving the coordination of services so they work together to improve health and wellbeing.”

Health

NAFDAC bans sale of Dex Luxury bar soap in Nigeria

The National Agency for Food and Drug Administration Control, (NAFDAC) has placed a ban on the sale of Dex Luxury bar soap in Nigeria.

The agency explained that the ban was due to Butyphenyl Methylpropional, BMHCA, content in the product.

This was contained in a post on the Agency’s X handle on Thursday.

According to the post, the European Union, EU, banned the product due to the risk of harming the reproductive system of users, causing harm to the health of the unborn child, and cause skin sensitization.

“Although this product is not on the NAFDAC database, importers, distributors, retailers, and consumers are advised to exercise caution and vigilance within the supply chain to avoid the importation, distribution, sale, and use of the above-mentioned product”, the agency added.

 

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Health

No outbreak of Lassa fever in any local govt- Kogi Govt

Nigeria identifies three drugs for Lassa fever treatment

Kogi State Government has debunked any outbreak of Lassa fever across the 21 local government areas of the State.

Commissioner for Health in the state, Dr. Abdulazeez Adams Adeiza while reacting to a viral video of an alleged lassa fever outbreak, noted that a student who was admitted to the Federal Teaching Hospital Lokoja did not die of lassa fever.

According to the Commissioner, it was reported that the student died of hemorrhagic fever.

The Commissioner explained that the deceased student who was admitted at the Federal Teaching Hospital Lokoja presented complaints of fever and bleeding from the gum.

He added that the patient was being investigated and managed, while samples were taken and sent to Nigeria Centre for Disease Control, (NCDC) Abuja, but before the result was released, he had lost his life.

The Commissioner said the result came out to be negative for lassa fever.

In his words, ”the suspected case has turned out to be negative for lassa fever.

“It is not only lassa fever that can make a patient to present bleeding from the gum. Other reasons could include blood dyscrasias and bleeding disorders”.

He advised members of the public to disregard the report as no case of lassa fever has been reported in the state

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Health

UCH workers directed to stop working by 4pm over continuous blackout

The Joint Action Committee (JAC) which is the umbrella body of unions at the University College Hospital (UCH) in Ibadan, Oyo state, has directed all employees of the health institution to commence work from 8 a.m. to 4 p.m. daily from Tuesday, April 2. 

The directive came after the tertiary health institution was disconnected by the Ibadan Electricity Distribution Company, (IBEDC) over N495 million debt accrued in over six years.

Addressing newsmen, chairman of JAC, Oludayo Olabampe stated that it is no longer safe to continue to attend to patients under the circumstances. He also said that workers would embark on strike if power is not restored.

He said;

“Workers would now work from 8 am to 4 pm only because it is dangerous and risky to attend to patients in that situation. We held a meeting with the management this morning but the issue is that there is no electricity. So, from today, Tuesday, April 2, we will work until 4 p.m. We are not attending to any patient after 4 p.m.

“This means that we won’t admit patients because the nurses that will take care of them will not be available after 4 p.m. and you don’t expect patients to be on their own from 4 p.m. till 8 a.m. the following day.

“If patients need blood tests, the lab will not work, if they need radiography, the radiographers will not work, and the dieticians in charge of their food too will not work after 4 p.m. We also gave management another 14-day ultimatum which started counting from March 27, and if after 14 days power is not restored, we will embark on warning strike.”

Commenting on the development, the chief medical director of UCH, Jesse Otegbayo, alleged that IBEDC was billing the hospital as an industry. He stated that the union did not formally notify management before making such a decision.

He said;

“I have not heard about that, if they are going to do that, they should write to management officially, and then the management will respond. There are rules that govern government service, you can’t just decide what hours you work and expect to be paid full-time.

“If they go ahead to do that without informing management officially, management has a way of applying the rules to pay them for the number of hours which they worked. The proper thing is for them to put it in writing because they didn’t write officially to the management before taking the decision.”

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