Editor's Comment


Do we need another commission?

Source: NHE Jan/Feb 16

While it is good to see real impetus behind a new cross-party commission on health and social care involving ex-health ministers from the three main parties in England, I do wonder whether they will simply end up re-treading the same ground that was combed over in exhaustive detail by the Barker Commission. 

The final report from that body is still available online and should be read, as should the plea from the same commissioners in November lamenting the lack of progress on the issues they raised, a year on.  

Unfortunately, because the Commission tackled head-on the big taboo about the hole in health and care funding and even suggested some alternative models, politicians felt they had to run a mile from it. The original September 2014 report advocated a single budget for the NHS and social care, new funding streams and changes to prescription charges, as well as more free care for those who need it – ultimately putting an end to the historic divide between the two sectors. It was followed up in June 2015 with ‘Beyond Barker’, which again restated the “overwhelming” case for change, for alignment between health and care, and for bottom-up, commissioner-led change – not top-down imposition and structural reform. 

The fact is, the way the NHS is funded and used is politically totemic and inviolable – but social care is not. Social care funding and how people pay is confusing for the general public and they just do not understand it in the same way as they do the NHS. Seeing as free social care in England is not going to happen any time soon (just look at the way the Dilnot recommendations on cost caps were watered down, then postponed to at least 2020), the politics of ‘alignment’ – both within Westminster and out in the country – are clearly hazardous for any government. 

As The King’s Fund makes clear on page 18 of this edition, a truly sustainable health and social care settlement seems as far away as ever. The effects of this failure are being felt across the system, and it is only thanks to the kinds of innovations and efficiencies that we cover elsewhere in this issue that the situation is not even worse. 

On a final note, this will be my last Editor’s Comment for NHE – I am departing the magazine to leave you in the capable hands of David Stevenson, who takes over from February. Thanks to all the readers and contacts who’ve made it such an amazing job to edit NHE since 2011.


Marvin   16/02/2016 at 21:16

Each hospital is crammed full of unnecessary administrative staff! These establishments are run like a hoarder manages - just as a hoarder will purchase more and more cupboards to put useless junk in so the hospital management open more and more useless departments resulting in a huge waste of money and a lack of efficiency! The NHS is likely to suffer even more problems in the future. The title of Doctor is much prized in certain regions of the world - and because we have a very large number of such populations in the UK - the parents are forcing their children to study to become Doctors, even when the young person does not want to become a medical practitioner. I am a teacher - I see this on a daily basis - and when I point out that the young person would gain much benefit for their future in helping voluntarily in the field, my suggestion is treated with great derision. This means that a great number of people training to be doctors are doing so just for the title and the personal benefit they gain among their own people - NOT for the benefit of the sick and dying people! This is so wrong! Those who wish to become Doctors should enter into nursing to begin with and then study further to become a doctor! This would ensure that such people are intent on helping others rather than themselves, and the NHS would receive a higher respect from the public - at present - anyone can be a medical doctor just by studying for a certain number of years as one would for any degree. Charging for car parking at Hospitals is disgusting! Making money out of other people's misery! That should also be abolished.

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