Labour health expert calls for immediate debate on health and care funding

Sir John Oldham, a former Department of Health adviser and GP, was commissioned by the Labour leader to lead a commission on “whole person care”, which reported earlier this year.

One of its recommendations was the commissioning of an “independent national conversation”, backed by all political parties that would “recognise the need for a longer term agreement with the people of the country on what health and social care should be, how and where it is delivered, and how it should be paid for”.

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Sir John told HSJ the Barker report on the future of health and social care - which identified a funding gap and some potential solution - supported “once more the necessity of having a national conversation”.

“None of the options for funding for health and social care are politically attractive and that is why it’s important to bring citizens along with you,” he said.

“The time is now to begin this because this is something that is not going to disappear.”

His comments come as Mr Miliband is understood to be considering addressing the issue of the NHS and care funding shortfall at the party’s conference later this month.

The Financial Times reported on Saturday that options under consideration included creating an earmarked “health tax”.

Sir John called on Mr Miliband and other politicians to begin the “national conversation” immediately.

He said the Barker commission report “sits well alongside” and adds to his own.

Sir John said of the debate: “It should start now. There’s been enough consensus [about the funding problem].

“We need to make decisions that inevitably this side of an election politicians will be reluctant to [make]. But we need to start that conversation.”

He said options including taxation, top up payments, other charges and limiting access to services should all be considered as part of an open conversation.

Sir John added that any decision by politicians to increase NHS funding more steeply than the flat real terms growth in recent years should come with a requirement that it reduce variations in provision and clinical practice.

He said: “Whatever it is it has to go along, in my view, with rigorous and vigorous reduction in variation.”

Sir John said variation in practice “between different hospitals and different general practices” was “hugely costly”.