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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.”

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Health

AIDS Agency Chief Says 1 Out Of 100 Persons Positive In Kaduna

The Executive Secretary of Kaduna State Aids Control Agency (KADSACA), Dr Isa Baka has said a survey had revealed that one out of 100 people is positive to the AIDS disease in the state.

Baka disclosed this speaking shortly after a walk in commemoration of the World AIDS Day, on Thursday in Kaduna.

The theme of the year’s’ World AIDS Day is “Equalise to End AIDS: Equal Access to Treatment and Prevention Services’’.

He said the present statistics was a remarkable development against previous survey which gave 11 of every 100 people in the state.

Baka added that the AIDS prevalence in Kaduna, which is at 1.1, being a survey carried out by the state government itself, was later done at the national level, where that of Kaduna was confirmed as very accurate.

“At the national level, the prevalence of the virus (AIDS) was at 1.4 (four people out of 100 test positive), while that of Kaduna is confirmed to be 1.1, was in determination of the state government and KADSACA’s efforts to ensure minimal prevalence of the virus,” he said.

He said as part of efforts to continue reducing the prevalence of AIDS in the state, government initiated programmes across the 23 LGAs.

He said one of the UNICEF anchored programmes, which is the ‘Adolescent and Youths Living With HIV and AIDS’ programme, was present and effective in at least, 18 LGAs and 24 sites in the state.

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Health

Malawi Commences Large Scale Malaria Vaccination- First In The World

Malawi has commenced large-scale vaccination of children against malaria.

This is the first large-scale malaria vaccination campaign since the World Health Organisation (WHO) endorsed the widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine in October 2021.

The endorsement followed a two-year vaccination programme, which involved more than 800,000 children in Ghana, Kenya and Malawi.

Recommended for children from five months of age to around 18 months, the vaccine  has an efficacy of 39 percent.

The first phase of the vaccination in Malawi is expected to cover 11 of the country’s 28 districts.

In a tweet on Tuesday, the WHO in Malawi said the expansion of access to the malaria vaccine will enable more children at risk of malaria to benefit from an additional prevention tool.

“Malawi has expanded access to the first malaria vaccine! The expansion of the RTS,S Malaria vaccine, into the 11 districts that participated in the malaria vaccine implementation program (MVIP) has been launched today. The vaccine offers a glimmer hope for Malawi,” WHO wrote.

Michael Kayange, Malawi’s national malaria control programme manager, told the BBC’s Focus on Africa that although the vaccine has low efficacy, “in malaria control, there is no single intervention that does it all”.

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Health

Nigeria Yet To Attain 70% Covid-19 Vaccination Coverage- NPHCDA

The National Primary Health Care Development Agency (NPHCDA) has disclosed that Nigeria is yet to achieve 70 percent coverage for COVID-19 vaccination.

Faisal Shuaib, executive director of NPHCDA, said on Tuesday that as of November 25, a total of 56,790,371 eligible persons targeted for COVID-19 vaccination are fully vaccinated while 12,492,646 are partially vaccinated in 36 states and the FCT.

“We are 21.6 million eligible persons away from reaching its target of fully vaccinating 70 percent of its eligible population by December 2022,” he said.

“But 62 percent of the country’s eligible population is at least partially vaccinated against COVID-19.

“The country has fully vaccinated half of the total population eligible for COVID-19 vaccination.

“We have also fully vaccinated an additional over 25 percent of its eligible population, in the last 110 days of SCALES 3.0 implementation.”

The executive director said 13.2 percent of fully vaccinated persons in the country have received the COVID-19 booster dose for additional protection against the virus.

He commended the COVID-19 strategy group for achieving 50 percent vaccination coverage in the country and promised that the momentum would be sustained.

Shuaib said he has also directed the team to intensify efforts toward the attainment of herd immunity.

“Until this is achieved, the strategy group will continue to develop strategies that will help the country achieve health security,” he said.

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