Labour’s integration plans could see NHS take over social care

Leading disabled campaigners have welcomed Labour’s plans for “full integration” between the NHS and the social care system, but have raised concerns about putting the NHS in charge.

Andy Burnham, the shadow health secretary, said he wanted to see “whole person care”, with “one budget, one service co-ordinating all of one person’s needs: physical, mental and social”.

Burnham suggested that the exclusion of social care from the NHS explained why it had never been able to break out of its “medical model” mentality.

He said that giving the NHS responsibility for coordination of both health and social care would allow it to “raise the standards and horizons of social care, lifting it out of today’s cut-price, minimum wage business”.

Burnham pointed out in a speech announcing his proposals that £104 billion a year was spent on the NHS but only £15 billion on social care.

He also launched a major health and care policy review, under the shadow care services minister, Liz Kendall.

Professor Peter Beresford, who chairs the national user-led Shaping Our Lives network, welcomed Burnham’s recognition that calls for integration were “unlikely ever to work so long as they are separate competing organisations, based on different funding systems and fundamentally different principles for access and entitlement”.

He said integration could not come soon enough, because of the “national emergency” intensified by “rising numbers of older and disabled people”.

But he said he was worried that Burnham “seems to be turning to the NHS for the solution” to integration.

He said: “This won’t work. It’ll mean an unhelpful return to a medical model when we know that a social approach is crucial here.”

He added: “It’s time Andy started talking to service users, carers and their organisations. They’ll give him a really helpful steer for developing sustainable policy.”

Sue Bott, director of development for Disability Rights UK (DR UK), said she was pleased that a national politician was “really trying to get to grips with the crisis that there is in social care”, and said her organisation was “very much in favour” of integration.

But she said she was concerned that the culture in the NHS was “very different” to that in social services.

She said: “Although we often have issue with the attitudes that disabled people experience in social services, nevertheless we would say that there tends to be a much better, empowering culture in social services.”

She said integration would need to be a “genuine coming together”, and added: “If it is simply the NHS taking social services under its wing, then that really is not going to work for disabled people.”

Bott said DR UK would support Burnham’s “whole person” approach, and recognised that the difference between health and social care services was “very arbitrary” and meant disabled people often failed to receive the services they needed.

Burnham also talked in his speech at the King’s Fund in London about the key issue of social care funding reform, but focused on older people and said nothing about working-age disabled adults.

Disability News Service asked Burnham’s spokesman whether the shadow health secretary agreed with proposals from the Dilnot commission on funding reform that social care should be free for all people with “eligible” needs who become disabled before the age of 40.

He said: “Andy’s been clear he supports the Dilnot proposals as an important first step to addressing the crisis in all social care.”

But when asked to clarify exactly what he meant by this, he failed to comment further.