A political consensus is emerging in support of pooling all NHS and social care funding, with the idea now openly backed by both the shadow health secretary and his Liberal Democrat counterpart.
At the NHS Confederation conference last week, Labour shadow health secretary Andy Burnham and Liberal Democrat health minister Norman Lamb both argued for a single health and care budget.
Mr Lamb told delegates he wanted to see a legal obligation on health and social care commissioners to pool their entire budgets.
“Ultimately I think the whole health and care budget should be pooled,” he said.
“It doesn’t make sense to have two separate budgets in a local area, two organisations doing the commissioning.”
He added: “We should end the disputes about who pays for care.
“The whole spectrum of care, from the social end to the acute end, is surely interrelated.”
He emphasised that this was a personal view and “not yet party policy”, but indicated he wished it to be included in the Liberal Democrat manifesto.
Mr Burnham later told the conference he wanted to see the “full integration” of health and social care services, meaning the creation of “a single service and single budget”.
However, creating a service fit for the 21st century would be “a 10-year journey”, he added.
Speaking to HSJ after the conference, Mr Lamb acknowledged that there was a “a shared view” between him and Mr Burnham that “we need to bring health and care together”.
He added: “Andy Burnham is arguing for a similar approach but where we are different is that he talks about a national health and care service.”
Mr Lamb said he favoured a more “permissive” approach.
“I would envisage that one may want to set a date, three or four years hence, when you would say ‘by this date we will pool the whole budget’.
“Set an end point but then allow different models to develop locally.”