National Care Service?

The Secretary of State for Health, Andy Burnham, wrote a piece in the Guardian today about his vision for a ‘National Care Service’

‘ providing personal care and support to adults on the basis of need and free at the point of use, will ensure that an ageing society remains a decent and fair society.’

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Andy Burnham and Ed Balls..

It’s hard to argue against that as a positive. Everyone wants good care and noone wants a price attached to it. All well and good so far.

He focuses on the disparity in the current system which places a burden on those who have property and savings and there is no doubt that there the current system is not ‘fair’ although the way that ‘fair’ can be interpreted is wonderfully flexible.

As for me, the rhetoric is pleasant sounding and hard to argue against. The fight will be in the details and don’t get me wrong, I’d love a system like this for all run on the basis of the National Health Service – but there is a real price to pay and trying to hide behind that fact or ignore the necessity for payment will just build unrealistic expectations.

People have different ideas about ‘fairness’ and ‘equity’. Personally, I think there is more of an obligation to help those who have the least resources to pay for the care that they need. I think if there were more focus on the money and the way the funding is divided, more money could be saved through properly thought through preventative services although there seems to be a tendency to veer from crisis to emergency at present and only providing care for the highest defined needs buys into this system – when a more substantial base of care at lower or ‘moderate’ needs may well prevent a more expensive longer term role for formal care.

On one element I do agree with him though, that the system that is churned out should not be voluntary – as the Tories ‘optional insurance’ suggests – if there is an inherent fairness, it needs to be universal. I know I’d happily pay a premium or increased tax if it were to produce a good quality system of equitable care for older adults and those with disabilities.

But there are more statements to be made and more talking to be done. Until the rhetoric morphs into concrete plans – which I have to say, I’m very much looking to – it’s a matter of waiting and seeing – and playing at politics until the election guides us to the way it might be taken forward.

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One thought on “National Care Service?

  1. My biggest worry is that whatever the rhetoric or system proposed, the end result in practice will be that the new system will be used to cut costs and services. This was the case with the in principle unarguable policy of Care in the Community and the Personalisation agenda is already being hijacked by Local Authority Treasurers to the same ends. The Resource Allocation Models of In Control are being used to set cost ceilings for care and consultants being taken on to target the most expensive (and most needy) ‘cases’. My own son is has Profound & Multiple Learning Disabilities with complex care needs and we are already up against these actions. (see Blog at )

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