Lords call for independent office to oversee NHS sustainability

The ‘short-sightedness’ of successive governments who failed to safeguard a sustainable future for the NHS have been slammed by the House of Lords Select Committee today, who released a report warning that the Department of Health (DH) had consistently failed to see and implement policies beyond the next few years.

In order to fix these problems, the committee made the recommendation for an independent Office for Health and Care Sustainability to be established that will look into health and social care for the next 15 to 20 years and report to Parliament on the impact of changing demographic needs.

The Lords’ recommendation also comes days after health organisations urged the government to ‘break the mould’ and form a long-term plan on tackling the problem with adult social care in the country.

The committee said that a political consensus was “not only desirable, it is achievable,” also urging the government to initiate cross-party talks and a meaningful “national conversation”.

It was also found that funding for health and social care was “too volatile” and badly co-ordinated between the sectors – meaning that resources were allocated in ways that did not meet patient need.

Lord Patel, chairman of the committee blasted DH, saying that at both the political and official level had been failing to think beyond the next few years.

“There is a shocking lack of long-term strategic planning in the NHS,” he said. “This short sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes not long-term solutions.

“To solve this, we need a new body that is independent of government and is able to identify clearly the healthcare needs of a changing and ageing population and the staffing and funding the NHS will require to meet those needs.

“This new Office for Health and Care Sustainability should be a trusted, independent voice as the Office for Budget Responsibility has become on economic forecasting and on public finance matters. It will need to look ahead and plan for 15-20 years into the future.”

Lord Patel added that there was a desperate need for the government to recognise that the NHS will need more money as spending will rise at least as fast as GDP for the 10 years after 2020.

“One area where more spending will be required is on pay for lower paid staff,” Lord Patel argued. “We are in an increasingly competitive international market for health professionals and a decade of pay constraint in the NHS has damaged morale and made it difficult to train and recruit the staff we need.

“We have heard much about the need to integrate health and social care and we think the best way to do that is make the DH responsible for both health and adult social care budgets.

“We also think it is time to look at the way care is delivered. This may well involve changing the model where GPs are self-employed small businesses. 

“Delivering health care fit for the 21st century requires improvement in primary care to relieve pressure on hospitals. That change should be delivered by GPs.”

Professor John Appleby, chief economist at the Nuffield Trust and an expert who provided evidence to the committee, said he was glad the committee had backed his call for an independent organisation to ensure the long-term sustainability of the NHS.

“It is crucial, as the committee recognises, that the health service can plan for steady funding increases that are in line with what experts recommend, rather than the current regime of feast and famine,” he explained.

“I hope that the committee’s conclusion that the current system of funding from general taxation is by far the most fair and efficient one will lay this question to rest once and for all”.

A DH spokesperson said: “We are totally committed to an NHS, free at the point of use, providing world-class care - and we agree that means taking decisions to ensure the sustainability of the service in future.

“That's why we are already expanding the number of medical training places by 25% to ensure we have all the doctors we need, investing in social care and working on a long-term funding solution in a Green Paper, and putting £325 million into local transformation plans to improve services, with more to follow in the autumn."

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