Give cash to social services and not the NHS, says health chief


Britain must stop “fetishising” the NHS budget and give more taxpayers’ money to councils, one of the health service’s leaders has said.

The political mantra of protecting the NHS is damaging the health service because hospitals are used as an expensive way to look after the elderly, Stephen Dorrell, chairman of the NHS Confederation and a former Conservative health secretary, said.

He said that Theresa May could not claim to support the NHS while starving councils of money for social care for the elderly, which he branded “insane economics and bad social policy”.

About £5 billion a year is needed to take councils back to the level of a decade ago and they should be at the front of the queue in next month’s autumn statement, Mr Dorrell said.

The plea reflects concern among health service leaders that stripping support from tens of thousands of vulnerable elderly people is filling hospitals to bursting point. Simon Stevens, chief executive of NHS England, has also said that extra money should go into councils. That, Mr Dorrell said, “reflects that fact that even NHS managers recognise that they can’t do their job properly if social care is falling over”.

Last year the government promised that the NHS England budget would increase by £8.4 billion a year by 2021, after Mr Stevens said that this was the minimum needed to keep up with demand. It would achieve this by cutting budgets for training and public health as well as a continuing squeeze on councils. The Commons health select committee has estimated that the true increase is £4.5 billion.

Mr Dorrell said that the political imperative to boast about a rising NHS budget was distorting care. “Fetishising the NHS budget and imagining it’s the only public service that relates to health is fundamentally to miss the point,” he said. “It is not true to say we are supporting the health service by asking it to do social care. We are using the health service as a very expensive social care service and then talking about efficiency. It’s insane economics and very bad social policy.”

Health spending has increased by a quarter in real terms over the past decade, but social care spending has remained flat. Councils have been restricting help with everyday tasks such as washing, dressing and mobility to those with the most severe problems, and 150,000 fewer people are getting help than five years ago.

A lack of services to keep elderly people well at home is blamed by NHS leaders for sending more patients to hospital and causing delays getting them out again. Bed-blocking has jumped by 25 per cent over the past year and is running at record levels, with 184,000 nights lost a month to patients who lack the support to go home.

“We would deliver a more efficient NHS and better health if we spent the money on supporting people out of the health service rather than waiting for them to become ill,” Mr Dorrell said.

He will repeat his criticism of “myopic” policy to MPs when he gives evidence to the health select committee today.

A spokeswoman for the Department of Health said: “This government is committed to making sure funding is used effectively right across the health economy. That’s why we are giving local authorities access to up to £3.5 billion extra for adult social care by 2020.”

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