Tania Mathias is an NHS doctor and former MP for Twickenham.
The new Government under Boris Johnson heralds positive news for the NHS and for social care. In the Prime Minister’s first statement to the Commons, and in his article at the weekend, it is clear that the NHS is a priority and that social care will also benefit from this reinvigorated government.
Already, the new Government has given a boost for the NHS: £1.8 billion over and above the pledge of an extra £20.5 billion by 2023/24 promised last year. There is every indication that this forward-thinking Government will continue to invest in and improve the health service: we have had pledges to address the pension problem for NHS staff and GP waiting times.
Furthermore, beyond these immediate policy statements is a commitment to address the changes needed in social care. These last need Conservative values: giving the individual power and choice wherever possible, while maintaining state services with a strong economy.
Wherever possible, people want control, and one of the greatest fears is not having control when you are at your most vulnerable. Individual concerns about social care for older people are often about fear: fear of losing independence, fear of losing the ability to live in your own home. The government’s social care policy must give certainty and transparency.
Certainty is needed both for staff and for the people receiving care. The Government has already given certainty for EU staff who are working here: EU staff have a major role in our health and social care services and the clear and unequivocal pronouncements of the Prime Minister ensuring rights for EU citizens living here are a welcome and significant priority in his first week in office. The statements about immigration with a possible Australian-style points system will also benefit social care staffing.
Certainty for individuals receiving care can come from social care, where the non-residential costs – i.e. nursing and a minimum level of personal care – is free at the point of need without means testing, and without the person’s home being part of the equation. An IPPR report of Lord Darzi and Lord Prior has given these bold ideas a costed analysis for free nursing and defined limited personal care. Their plan removes the current anomaly whereby a person needing care for cancer-related needs gets more financial help than a person needing care with dementia related needs.
The Scotland experience indicates that, while large investment is needed initially, there are savings in the longer term. Importantly, family carers who are trying to balance jobs and caring for their loved ones are able to have more quality time with their relative if the state provides a certain level of personal and nursing care. There are different payment models: increasing national insurance or government insurance schemes. This Government can give clarity and reassurance that NHS and social care really can be cradle to grave.
It has the benefit of continuity in the Secretary of State, Matt Hancock, and the Long Term Plan. The latter illustrates examples where there are integrated care systems already in place that coordinate the NHS and social care and minimise the problems – such as delayed transfer for someone moving from hospital into care back in their own home or in a residential care home. Putting the patient at the centre of all decision making in this integrated system will decrease the fear that comes from uncertainty, and will also enable end of life care where the person’s wishes are at the centre of all decision making.
This Government is showing clear commitments which will make this one of the most impactful governments not only for Brexit but also for the NHS and social care.