Social care and barriers to reform – Yorkshire Post Letters

I NOTED with interest Mike Padgham’s call for the merging of NHS healthcare and social care in his Saturday Essay article (The Yorkshire Post, February 27).

It is now almost a quarter of a century since the cross-party Commons Health Committee, which I was chairing at the time, made exactly this recommendation to the then Government.

The experience of subsequent years, with the ongoing difficulty of trying to determine if individuals with conditions such as dementia should receive free healthcare or be means-tested for social care, has strongly reinforced the logic of such a policy change.

The Covid pandemic has exposed this organisational split as frankly dangerous to our public health.

It is encouraging that, as a spokesman for the so-called ‘independent’ care sector, Mr Padgham goes beyond the usual plea from private home operators for an increase in residents’ top-up fees from local authorities.

But, in arguing for merging health and social care, I wonder if he has fully thought through its implications for the private care sector.

Will it ever be possible to achieve a fully integrated health and care system while we have an almost wholly state-run NHS alongside an almost wholly privatised care sector?

I started working in social care while in my teens over 50 years ago when most of that care – domiciliary and residential – was provided by local authorities. I would not claim that the quality of that care was consistently better than that of today, but I genuinely believe the relationship with the NHS at a local level was much more coherent.

Following Covid, the Johnson government now appears to be recognising that a market approach to health provision has a distinct downside.

Perhaps, in due course, they will also understand that the fragmented care market, begun under Mrs Thatcher, is also a fundamental barrier to the delivery of properly integrated health and care.

From: Sam Willmott, Bingley.

I CONTINUE to be impressed by the extent to which you continue to focus on the Government’s neglect of social care reform on your pages – your persistence is admirable. The columns by Mike Padgham should be required reading for every Cabinet minister and MP. I look forward to hearing their responses – if they can be bothered.

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