Exclusive: Dorrell calls for NHS ‘change fund’ and social care ringfence

In his first interview since becoming the new chair of the NHS Confederation, the former health secretary and Commons health committee chair added his voice to calls for an NHS transformation fund to be included in November’s comprehensive spending review.

Mr Dorrell said: “One of the things which I would personally think would help would be a change fund.”

He said the King’s Fund and the Health Foundation had made a “very powerful case” for the creation of such a fund to pay for the “parallel running” of services as the NHS shifts to new models of care.

When asked how big the pot should be, Mr Dorrell said he would not “put [his] name to a precise number”. However, he suggested it should be a “revolving fund”, with recipients drawing resources for a defined period of time to pay for the double running of services, and then replenishing the fund.

Mr Dorrell also said the protection of NHS funding should be extended to social care.

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“If [health and social care] is a joined up service, which is what I think it ought to be… then you can’t fund part of it, defined as the NHS, and leave the other part of the single joined up service without adequate funding – it doesn’t work,” he said.

His two priorities as NHS Confederation chair will be “around money and… structure”, he said.

He added that “a clear resource framework” had to emerge from the spending review, giving clarity “over the lifetime of this Parliament [about] what the resources available for the health service are going to be”.

‘There has to be a clear year by year plan so people know what they’re dealing with’

“It’s no good just leaving it vague, that there’s £8bn coming sometime… There has to be a clear plan on a year by year basis so people know what it is they are dealing with,” he said.

Without this it would be “impossible” for frontline and management staff to develop plans to deal with operational and financial pressures, Mr Dorrell added.

On structure, he said there had to be “greater clarity around the respective roles of the different parts of the system, and a simplification”, but “a huge legislative initiative” was the last thing the NHS wanted.

This simplification should apply to health and social care commissioning, where there are “far, far too many commissioners all tramping over… the same space”, as well as the roles of arm’s length bodies.

When asked what the NHS Confederation’s role should be, given the existence of other membership groups such as NHS Providers and NHS Clinical Commissioners, Mr Dorrell said: “The answer lies in the [name] that it’s actually a confederation. What we want is a joined up health and social care system and there certainly needs to be collaboration between the different representative bodies.”

The confederation would allow “several voices” to speak with a “single clear view”, he added.

Mr Dorrell said he did not foresee his role as a senior adviser with KPMG being a “major issue”. However, he said that in any circumstances where a conflict could arise he would take himself “out of the discussion on both sides”.