The House of Commons Select Committee on Health has published its review of public expenditure in health and social care.
The cross-party Committee, chaired by Conservative former Health Secretary Stephen Dorrell, found that it was only possible to meet the NHS’s target of generating 4 per cent efficiency gains year on year for four years – £20bn by 2015 (the Nicholson challenge) by making fundamental changes to the way care is delivered, to introduce more integrated, patient focussed care.
The report states that “health and social care must be seen as two aspects of the same service and planned together in every area for there to be any chance of a high quality and efficient service being provided which meets the needs of the local population within the funding available.”
The Committee found that local authorities are having to raise eligibility criteria in order to maintain social care services to those in greatest need. Councils were cutting social care budgets by an average of 6.6 per cent while raising charges for services such as home help. Moneywhich should have been spent on integrating the NHS and social care had gone on propping up current services.
Savings were being made in the NHS by “salami-slicing” existing processes instead of rethinking and redesigning the way services are delivered. It concluded that the controversial move to GP commissioning being piloted by Health Secretary Andrew Lansley is complicating the push for efficiency gains. “Although it may have facilitated savings in some cases, we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings.”
The Committee found “precious little evidence” of urgency being given to achieving greater service integration between health and social care that the needs of the country’s ageing population demands