The deputy prime minister is pushing for next year’s NHS budget to be topped up with enough winter pressures funding to leave the service in a “healthy state” for the next government.
Nick Clegg told HSJ in an exclusive interview he was working with Chief Secretary to the Treasury Danny Alexander to ensure the “right amount” of funding for 2015-16 was built into December’s autumn statement.
“We need to make sure as custodians of the NHS that we hand on the NHS in a healthy state to whoever comes into power next,” he said.
“That’s why for me and for Danny [Alexander] in our discussions with David Cameron and George Osborne, right at the top of our list of priorities will be to ensure we set aside the right amount of money such that any winter pressures in 2015-16 will be properly catered for.
“I think that is an act of basic good governance.”
In a wide ranging interview, Mr Clegg also defended the Health and Social Care Act reforms and criticised shadow health secretary Andy Burnham for his tendency to “rant and rail”.
He described the significance of the coalition’s health and social care integration project as “difficult to exaggerate” and admitted some clinical commissioning groups had failed to properly implement the government’s parity of esteem agenda on mental health.
Mr Clegg, who announced a £120m investment in mental health during his speech to the Liberal Democrats’ party conference this month, defended the government’s record on mental health.
He argued the coalition had “got cracking quite early” on parity of esteem but accepted the challenge was “to persuade as well as instruct the NHS”.
The deputy prime minister said his party had made clear its opposition to NHS England’s decision to impose greater funding cuts on mental health than acute trusts.
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He also pointed out that many decisions on mental health were out of government hands.
“We had the issue, and we were open about it, with the tariff deflator and generally money for mental health is not ringfenced so we are dependent on decisions being taken by CCGs and senior managers across the NHS,” the deputy prime minister added.
“Do I wish that all commissioners had from day one attached the importance in the commissioning decisions to mental health that I think it deserves? Of course I do. Have they all done it? No.”
Mr Clegg defended the government’s decision to pass control of commissioning decisions from Whitehall to NHS England, a move that has curbed ministers’ ability to step in.
Asked whether the Health Act reforms had left care minister Norman Lamb powerless to intervene when he disagreed with commissioners’ decisions, Mr Clegg said: “No not at all.”
“We are moving away from an NHS where there is a series of buttons in the minister’s office in Whitehall that can be pushed and effortlessly things happen on the ground,” he added.
“One of the lessons surely we have learned from the past is that a command and control NHS does not work.”
He added: “The way money circulates in the NHS these days is through decisions taken by the CCGs, that is the whole point of the new architecture.
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“The message to commissioners in the NHS is very clear: mental health is a priority today and will remain so in the future, and that has to be reflected in their resourcing decisions.”
Mr Clegg strongly criticised Labour’s health policy and said it completely denied “anything they ever did in the past”.
When shadow health secretary Andy Burnham was in government the party had “merrily [provided] more contracts to the private sector than any government had done previously… and now they just rant and rail against any kind of diversity in health provision”, Mr Clegg said.
“The difference between ourselves and Andy Burnham is that through the [better care fund] we are actually putting our money where our mouth is to ensure that integration has to take place.”
He described the significance of the fund as “difficult to exaggerate”. He said the government had sent a clear signal of its intention to integrate organisational budgets.
While there was no “magic wand solution” to the rising cost pressures on the NHS, he pointed to a “virtuous circle” of integration and parity between mental and physical health services.
This was the “route by which you can put the NHS on a more sustainable footing”, he added.