…political “unsayables”. Behind closed doors nearly every politician admits that the current system for paying for health and social care is decades out of date.

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Its one of the political “unsayables”. Behind closed doors nearly every politician admits that the current system for paying for health and social care is decades out of date.

But very few of them are willing to say publicly that reform is long overdue.

Even though the government is this Thursday expected to announce that councils will be able to raise a bit more cash from their taxpayers towards paying to care for our elderly with dignity, few in Westminster would pretend that’s anything like a long-term solution.

So what is? Sources say the Cabinet Office is looking at various mechanisms to find some answers.

But whatever they come up with, it won’t be easy to get other political parties to buy in, especially with a small majority. So maybe it requires a different kind of fix.

The BBC has been told that Number 10 was considering plans for a cross-party commission to look at the costs of health and social care, before the referendum.

After three former health ministers – Norman Lamb, the Liberal Democrat, Stephen Dorrell, a Conservative, and Labour’s Alan Milburn – launched a bid for a national review to find consensus, David Cameron’s team invited the three to present their plan to the government, in a seeming acknowledgement that the current system is not sustainable.

Norman Lamb told me: “We went in and talked to them and presented them with a paper and then the whole run-up to the referendum took over and we never got any response from that and then of course there’s been a change of government but the need for this government to engage in this and for all parties to stand up to their responsibilities as well, to join a process, to ensure that we reach a one in a generation settlement for the health and care settlement I think is absolutely fundamental.”

When asked what he would say to Theresa May’s team, Mr Lamb replied: “Engage. Talk to us now.

“There is an urgency about this. If you keep sleepwalking towards the edge of the precipice, real people up and down our country will suffer.”

Baroness Cavendish, who held the talks in Number 10 said: “I was very attracted to the idea that we might be able to get cross-party air cover for a solution….. we all know that the 1948 NHS created a system that is now not fit for purpose because it doesn’t address the new challenges.”

She said she did not think the “impasse” could be solved without a process that involves all political parties.

Some ministers are known to be encouraging Theresa May’s government to consider the idea of a commission. One of its supporters in government told me “there is a recognition that as a civilised society we need to spend more”.

But another minister said there also had to be a conversation about how much families had to contribute and that maybe “people’s expectations” had to be modified.

Changes in our society make this one of the hardest questions ministers need to answer. There have certainly been plenty of attempts before.

But the reality of what many councils – and more importantly, thousands of families – are now experiencing in their lives, makes it day by day harder to ignore.

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Simon Johnson reports in the Telegraph (Scotland) 12th December 2016: Scottish breast cancer patients denied drug approved for English NHS 

Julie Anne Barnes reports from Scotland: Breast cancer test which could spare patients chemotherapy available on NHS … except in parts of Scotland – The genetic test, which is not available in three NHS Scotland areas, gives sufferers the option of avoiding chemo when it’s not needed.

Helen Puttick in the Times 15th December reports: Patients still suffer from NHS drugs rationing whilst “Shona Robison, the health secretary, announced fresh reforms which she said would give people better access to the latest drugs”, to try to mitigate the situation.

BBC news reports 17th December 2016: Breast cancer drug Perjeta refused for use in Scotland

The Economist opines: Taxes will rise to fund care for Britain’s elderly: A “sticking plaster” solution for a system that “needs a quadruple bypass”


This entry was posted in A Personal View, Commissioning, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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