Health and social care relationship – too broken to fix?

“CIPFA has called for the creation of independent commission on health and social care to devise how to fund provision in the future after experts raised concerns about how the system would cope with rising demand.

Experts brought together by PF and CIPFA as part of the Public Finance Perspectives series concluded that urgent and radical reforms would be needed. Contributors included The King’s Fund’s senior fellow social care Richard Humphries, The Health Foundation’s director of research and economics Anita Charlesworth and CIPFA’s head of health and integration faculty Jane Payling.

In Funding a Healthy Future, they highlighted the sector is facing increasing uncertainty due to Brexit and its implication for the health and social care budget, research capacity and employment prospects.

Social care was identified as among the most pressing concerns among many contributions as it must function well for the NHS to remain sustainable. However, severe funding pressure could lead to it reducing the services provided, which the experts said would have a knock-on effect on the health service.

An independent commission should be formed to consider what options are available to balance demand and supply. Also, CIPFA called for the introduction of a so-called ‘golden ratio’ of 10%, which is the proportion of national gross domestic product that is ring-fenced for health and social care spending. This would reduce the unpredictability of politically-driven decisions on funding, and provide a logical benchmark for what the nation can afford to spend on the area.

The alternative is that the public would see an increase in the rationing of services, significant tax rises or charges for using the NHS and social care.

CIPFA chief executive Rob Whiteman stated that without radical transformation, the government would struggle to ensure the NHS and social care system will be sustainable for future generations.

“Indeed, the concerns of leading experts that CIPFA has gathered clearly demonstrate that the sector is already creaking under the strain,” he stated. “To protect services, the severe financial stress the sector is under must be confronted with great urgency.”

This meant tough and politically unpopular choices would have to be made in order to ensure the quality of health and social care services, he added.

“CIPFA believes that a commission must be set up to explore these difficult decisions. It should also introduce a golden ratio of GDP spend on healthcare to protect funding from the unpredictability of short-sighted political decisions.”