THE government plan to set up a £3.8bn a year fund to amalgamate health and social care, has collapsed and has been ‘postponed’.
The Cabinet Office has called a ‘temporary halt’ to the so-called ‘Better Care Fund’. £1.9bn of this £3.8bn a year, was to have come from the NHS hospital budget of £40bn a year.
The idea was to launch the plan last week and start taking the money from NHS Hospitals in April 2015, just before the general election.
It is now reported that the Cabinet is running scared about the timing of the plan. The details of moving so much money out of hospital care into community care, when many acute hospital trusts are running huge deficits, has been challenged as inadequately thought out and too abrupt.
The key government advisor from the Kings Fund, Professor Chris Ham, has described the current plans, as ‘completely unrealistic’. He however ‘supports the purpose of the Fund – to support the integration of health and social care – as well intentioned.’
Sir Bruce Keogh, Medical Director for NHS England, has said that there is ‘scepticism’ that the money will fund the intended projects and that ‘it will be used for filling pot holes and other significant things’ by local government.
Despite the temporary halt, the government is committed to the strategy of amalgamating the health and social care budgets, to redesign services and reduce acute NHS hospital care. The full thrust will take place after the 2015 election.
As healthcare is free and social care is means-tested, the door will be opened for charging for all healthcare. This year already, the Department of Health handed over £1.1bn of NHS money to local councils for social care, £200m for the Better Care Fund.
On the basis that the £3.8bn fund would go ahead the King’s Fund had marked down years 2015-16 as the ‘period of the cliff edge’, when the deadly situation of 40 bankrupt NHS trusts would be worsened by a further £1.8bn of NHS funding being diverted away from NHS hospitals.
The King’s Fund stated that the NHS management and government had ‘risen to the challenge with pay restraint, cuts in central budgets, and the abolition of some tiers of management producing significant savings.
‘But the strongest pressure has been applied and felt at the front line, by hospitals and other local service providers, faced with squeezing more and more value from every health care pound.’
It predicted that NHS spending as a proportion of gross domestic product (GDP) ‘will fall from its peak of eight per cent in 2009 to just over six per cent in 2021 – equivalent to 2003 spending levels.’
It added that ‘The NHS and social care face enormous challenges over the next 18 months. To avoid a major crisis – in terms of widespread overspends, decreasing quality of care, or both – the NHS needs more time, more money for transformational change and short-term support and measures to support change and value for money.’
The Fund finally warned that ‘With more than a quarter of trusts already in deficit a financial crisis is now inevitable in 2015-16’, and concludes that the NHS going bust ‘is only a matter of time.’
The coalition has decided that such a scenario could only be carried out after the 2015 election.