Care minister Norman Lamb has told HSJ that he wants to create a single government department for health and social care by joining budgets at a national level.
In a wide ranging pre-election interview, the Liberal Democrat minister said the government should lead by example by integrating budgets at a national level.
Mr Lamb also:
- said he “would love” to continue as a health minister in the next Parliament, saying he was “on a mission, particularly on mental health”;
- expressed horror that clinical commissioning groups are holding back funding rises for mental health, as reported by HSJ last week; and
- became the first minister to call for the NHS Trust Development Authority to merge with Monitor.
He said that after the May general election a new financial settlement needed to be agreed for health and social care nationally, and that this should be done within “a new department for health and care”, established immediately after the election.
“Can anyone argue against it?” he asked.
Restating his view that health and social care budgets should be fully merged locally by 2018, Mr Lamb said: “To match that nationally you’ve got to have a department for health and care.
“It’s ridiculous that we have funding for the health and care system flowing through two different government departments and endless negotiations between two. It has to be one department.”
The proposal is not official Liberal Democrat policy, but is being considered for the party’s election manifesto.
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Mr Lamb said policies on integrated care were now “not that different” between the Liberal Democrats, the Conservatives and Labour.
He added that while Labour was now officially calling for NHS trusts to be “preferred” providers, his position on the issue was identical to that of shadow health minister Liz Kendall.
Ms Kendall has recently said the private sector will continue to have a role in providing NHS care, although she does not believe NHS reform should simply mean private companies doing more.
“There’s nothing between me and Liz on this at all,” said Mr Lamb. “I just want to get the NHS functioning effectively and I want it sustainable, so of course I’m willing to work with other people to try and achieve that and I’m not desperately tribal about the way I try and do politics.”
He warned that the health and care system “will crash” in the next five years without extra money. But, he pointed out that further investment in the NHS depends on current levels of social care spend being maintained. He added: “There is no party at the moment that is committing to increase social care [funding].” This includes the Liberal Democrats, although party sources argue that under its economic plans, social care funding could rise after the national budget deficit has been eliminated.
Mr Lamb’s plan for a single health and care department was backed enthusiastically by Richard Humphries, assistant director of policy for the King’s Fund. He said: “It’s a good idea. It is completely logical. At the moment you have one department responsible for policy, and another responsible for the budget. The centre needs to practice what it preaches [about pooling resource].”
David Pearson, president of the Association of Directors of Adult Social Services, told HSJ that he was “agnostic” about which department the social care budget sits in. He said it was more important that social care funding was protected, and increased in the next parliament to reflect the expected growth in need for social care services.
However, he argued that while the NHS and social care budgets should be “aligned”, they should not be completely merged, as social care still had a distinctive offer.
“We don’t want to add it to a big pot, and then see it drift towards the acute sector as has happened with mental health and primary care spending,” he said.