Hospitals poised to become ‘warehouses of older people’

To meet the needs of an ageing society the three “fragmented” services need to be made into a single service, Andy Burnham will say.

In a speech later today, Mr Burnham will claim that current arrangements are outdated, stating that there are “dangerous” gaps between services which put the vulnerable at risk.

Mr Burnham will propose that all three services should be integrated with a single pooled budget of £119bn a year.

He is expected to say: “As we live longer, people’s needs become a blur of the physical, mental and social. It is just not possible to disaggregate them and meet them through our three separate services. But that’s what we’re still trying to do. So, wherever people are in this disjointed system, some or all of one person’s needs will be left unmet.

“Right now, the incentives are working in the wrong direction. Services won’t be financially sustainable in this century.

“For older people, the gravitational pull is towards hospital and care home. For the want of spending a few hundred pounds in the home, we seem to be happy to pick up hospital bills for thousands. We are paying for failure on a grand scale, allowing people to fail at home and drift into expensive hospital beds and from there into expensive care homes.

“The trouble is no one has the incentive to invest in prevention.

Mr Burnham will add: “Councils face different pressures and priorities than the NHS, with an overriding incentive to keep council tax low. So care services have been whittled away, in the knowledge that the NHS will always provide a safety net for people who can’t cope.

“In their defence, councils and the NHS may be following the institutional logic of the systems they are in. But it’s financial madness, as well as being bad for people.

“Hospital chief executives tell me that, on any given day, around 30 per cent to 40 per cent of beds are occupied by older people who needn’t have been there. If we leave things as they are, our district general hospitals will be like warehouses of older people – lined up on the wards because we failed to do something better for them.”

Health Secretary Jeremy Hunt said: “I welcome the fact that Labour have finally recognised the importance of integrated care, but they had 13 years to achieve this and failed to do so. In fact, the system they left was fragmented and focused on treating patients as a collection of conditions not as individuals. In the last two years we have put patients at the heart of the NHS by allowing GPs, who understand the sometimes complex conditions of their patients, to commission services to meet their personal needs.”

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