Paul Bristow is the MP for Peterborough and a member of the Commons’ Health and Social Care Select Committee.
Last month I took part in a rare report launch: one where the authors were campaigning for reforms which would save rather than cost money. Look Ahead Care and Support estimates that nearly £1bn could be saved annually if integrated mental health, social care and supported housing services, were rolled out across England.
The report was compiled by consultancy Europe Economics and provides a robust analysis of the cost savings yielded from keeping people with mental health problems out of hospital, through supported housing.
The reality behind the numbers was vividly brought to life at the online launch, which began with a short video from service users. One had the hairs standing up on the back of my neck as he said Look Ahead made him feel “like a king” simply because – for the first time – he had access to his own private shower. These small, but incredibly significant, humanising differences between long-term hospital care and being supported to live independently are very striking.
The sad truth is that there isn’t presently enough money in the social care system to sustain it. As the Chancellor said in his Budget last week, unprecedented spending can’t continue, so any means by which money can be saved while improving outcomes are something to be welcomed. It is a big missed opportunity that only a handful of NHS trusts and local authorities are adopting the kind of integrated approach advocated and provided by Look Ahead.
At the launch, we were asked what the main barrier was to making this way of doing things more widespread. For me, the answer is culture.
That is not to cast aspersions on individuals working in the system, but local authorities and local CCGs – for example – are just not set up well enough to work together. There can be a ‘not invented here’ ethos, which has to change if we are to achieve the much vaunted (cross-party) ambition to integrate health and social care.
As for so many of us, social care is not just a political but a personal issue to me. My parents both worked in the sector and bringing about reform motivated me to seek election as an MP. In the Commons, so far I’ve been vocal about the fact that the work and extraordinary sacrifices made by those in the sector have not properly been appreciated by those in positions of influence. It has also been clear for years that a long-term plan to reform social care is urgently needed.
The Covid-19 pandemic has brought the whole question into even sharper focus, with a spotlight on many of the fundamental problems in the system, most of which stem from a silo culture and a severe lack of funding. To bring about reform that stands the test of time will require innovation and leadership on the part of our own party, but also political courage and long-term thinking on the part of the opposition. It is the tendency for social care funding to become a political football which most inhibits progress.
Over the past two decades, we have seen at least a dozen government papers on social care reform but white papers can only set out ambitions: it is legislation and political will that will achieve them. And because social care is not just about old people, but about vulnerable people across the age range, supported housing is a key part of the picture.
I would urge colleagues across the Commons to read the report and work together to implement its recommendations. As we emerge from the pandemic, the need for mental health services will only grow. Integration of those properly with social care and supported housing is long overdue.
There is an opportunity here to provoke reform every bit as profound as creating the NHS in 1948. It is up to us to seize it.
Paul Bristow MP is Conservative MP for Peterborough and a member of the Health and Social Care Select Committee