Torbay or not Torbay
I recently attended the launch of Labour’s health and care policy review at the King’s Fund. The Rt Hon Andy Burnham MP, Shadow Secretary of State for Health, introduced his vision for 2015.
Whilst Andy has previously spoken about his goal of bringing into existence an integrated health and social care system, there was a real sense of excitement in the room, potentially as the proximity of the election makes these plans appear closer to fruition.
Working under the assumptions that if Labour comes into power in 2015 they will be operating in a tight financial climate for the foreseeable future and that the NHS will not be able to withstand any more top down reorganisation, Burnham confirmed that Labour would repeal the Health and Social Care Act. Andy spent much of the speech discussing how he would like to create a system that saves money by incentivising preventative care.
As Andy noted, the case study for whole person care (i.e. mental, physical and social streams working together so that there is one point of contact) is Torbay, where the NHS and Council have experience of working with an integration model. Since 2005, the Care Trust in Torbay has been responsible for commissioning and delivering health and social care services. There is a single point of contact for health and care. The Trust also works in cooperation with NHS providers, local authorities and with voluntary sector organisations. As an example of how such a system would work, Mr Burnham suggested that if a pensioner went into hospital, a care worker would support them and help ensure that a bespoke package of care would enable them get home as quickly as possible.
David Brindle, writing in The Guardian, in arguing for an independent assessment of case studies such as Torbay, points out that Torbay’s integration model did not arrive without difficulty. For example, harmonising pay and conditions for Government workers and NHS employees was problematic. Furthermore, he notes that former Care Services Minister Paul Burstow’s contention that Torbay represents cultural changes, rather than structural and “that it did not lead to any significant transformation across the service.”
For his part, Chris Ham, Chief Executive of The King’s Fund, whilst broadly welcoming the proposals, questioned how such radical changes could reasonably be brought about without instigating further structural change.
The Shadow Health team will now be seeking input on their plans on whether such integration is welcome and, if so, how much of it would be applauded – Torbay or not Torbay.