Andrew Lansley has revealed he has “various proposals in mind” for a cap on the maximum payment on care home costs any individual faces.
The health secretary was quizzed yesterday by MPs on the health select committee on the recently published social care white paper and progress on implementing funding reform proposals from the Dilnot commission on care funding.
However, he refused to be drawn on details such as the level of a proposed cap on the amount people would have to pay towards care home costs and how the “Dilnot package” might be funded although he admitted he probably did have “various proposals in mind”.
“But I don’t think it’s very helpful for me to start putting them out there rather than for us to have a proper engagement that tries to build consensus,” he told the committee.
He hotly denied a suggestion the Dilnot proposals had been “kicked into the long grass” and claimed government was making “all the progress we possibly can”.
MPs also asked how government would bring about integration between health and social care and ensure NHS cash transferred to social care was not simply being used to prop up existing services.
Mr Lansley said councils were “using the NHS transfer positively” and a further £300 billion in joint funding from 2013 to 2015 would boost the creation of integrated services, which would be a priority for health and wellbeing boards and CCGs.
“CCGs will be looking for the money they’re transferring to local authorities to benefit their patients in that way and hopefully the fact they’re sitting round a table as a health and wellbeing board, constructing integrated commissioning plans, should help to drive this forward,” he said.
He did not rule out health and wellbeing boards and CCGs setting up care trust style arrangements to commission services.
“Under the Health and Social Care Act, we’ve carried forward all the legislative provisions to enable people to create what is effectively a care trust organisation. It is perfectly possible to do that,” he told the committee.
But Shaun Gallagher, acting director general of social care, told the committee it was vital health and wellbeing boards were not simply joint commissioners that “were only there to talk about the money”.
“The role of the health and wellbeing board must be broad leadership across the entire health and care economy and the population that they serve,” he said.
Mr Lansley also said all of the £1.6 billion NHS underspend will go back into the health service
“The NHS, through [strategic health authorities] and [primary care trusts], had an underspend in 2011-12 of just about £1.6 billion,” he said.
“All of that has been carried forward for SHAs and PCTs so it is available to [their successor bodies] in future years.”
He said that if the cash remained unspent in 2012-13 it would be part of the transfer of resources to the NHS Commissioning Board and clinical commissioning groups.
“It’s one the reasons why we can now be increasingly confident that CCGs will start their task on April 1 2013 with no inherited debt,” he added.
He also denied a Department of Health underspend had been “clawed back”. “It’s just not spent,” he said. “It’s not like they gave us the money and we handed it back to them.”