05.06.14
Lamb tells Confed: pool all health and care budgets
Health minister Norman Lamb MP has backed the idea of single pooled budget for health and care in every local area, along with joint commissioning of both, suggesting it’s an idea he’d like to see in the Lib Dem manifesto ahead of the next election.
The care and support minister, giving the first keynote speech on day two of the NHS Confederation annual conference in Liverpool, did not shy away from discussing the “extraordinary pressures” the NHS is under as budgets fail to keep up with rising costs (4% a year, he said), but he said integration is part of the answer.
The 14 Integration Pioneer sites – for which he announced an extra £1.2m of funding today, to be split between them £90,000 each – are doing a great job of experimenting, innovating, evaluating and disseminating good ideas, as are plenty of other areas informally.
Too often, Lamb said, staff don’t feel empowered to innovate, but they must, because more engaged staff have a direct improvement on patient care and make stretched budgets go further.
But it was his declaration that “ultimately the whole health and care budget should be pooled” that got the biggest reaction, especially his talk of a legal obligation to pool resources in this way and “end the dispute about who pays”.
Dr Steve Kell, NHS Bassetlaw CCG chair, who was on a panel with Lamb after the speech, said a top-down diktat on this was wrong and that each area should make its own decisions.
He followed this up later with a statement from NHS Clinical Commissioners, where he is the leadership group co-chair, saying: “By sending a top-down edict to pool budgets there is a significant risk that we will lose the clinical leadership that is already driving forward positive change and health improvements for patients.
“Pooling budgets may be appropriate in some areas but this should be determined by local clinical leaders who are in the best position to determine local arrangements with their populations…Mandating pooling budgets will only bring politics closer to the NHS and could results in another wholesale top-down reorganisation.”
Indeed, that worry has been a common one today on social media and around the conference, with many delegates questioning how such a big change could possibly be achieved without more disruptive structural change to the NHS.
Audience members asked Lamb how pooled budgets and joint commissioning can work when data is still not shared properly between the sectors due to incompatible systems or bureaucratic hurdles, and he admitted this is a problem. But Lamb said it had to happen, and that new guidance coming out of the Department of Health would make it easier to do so.
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