04.09.14
Who should pay for free social care?
When we interviewed Professor Julian Le Grand of the Barker Commission earlier this year, he said: ‘I don’t think we should be deterred in any way by worrying about the political reaction’.
By this he meant that a radical problem required a radical solution, and that the Commission wasn’t ruling out recommending new NHS charges to pay for more free social care, for example.
The Commission’s final report, launched today, has shied away from that option, which is politically very sensible. A report recommending NHS charging in the run-up to a general election would have forced politicians of all stripes to run like mad (case in point: compare and contrast the tone of the government's response today with Norman Lamb's frostiness when the interim report came out).
The problems it identifies are very real, centred on the iniquities of access and quality that exist between the free, sacrosanct NHS – and the means-tested, expensive world of social care, which few people not trying to navigate really understand.
So, its recommendations on where to find the money are politically more viable, but not without controversy: the changes to NHS Continuing Healthcare and ending many prescription charge exemptions (albeit while cutting prescription costs) are in effect ways of charging for currently free NHS services, but more subtly.
The report is required reading – funding and charges are just part of it (its recommendations on commissioning also need serious thought).
Find it here: www.kingsfund.org.uk/publications/new-settlement-health-and-social-care