Charlotte Atkins

Opposition leader, Staffordshire County Council and Labour County Councillor for Leek South

NEXT month, with yet another reorganisation of the NHS, the new buzz phrase is Integrated Care.

We all want health and social care services to be more joined up. Supposedly, health and care teams will be supported to deliver a ‘whole person’ approach to care with an integrated care record and shared information technology systems.

But, as always, finance is at the heart of the issue. Can services be truly joined up without a pooled budget? I doubt it because each care provider, whether it be the NHS or the council’s social services will be protecting their own tight budget.

In April, the Government is imposing a national insurance hike, increasing income tax by 1.25 per cent on families just as they are facing increased council tax bills and the terrible toll of rocketing energy and food prices.

This tax hike is to tackle the NHS backlog and pay for social care changes.

It will raise £36billion but only £5.4billion is ringfenced for social care.

That is despite local councils constantly telling the Government that the social care sector is in urgent need of funding to prevent its collapse.

A ludicrous situation exists at the moment. If you suffer from cancer, you are looked after by the NHS and are fully covered by national insurance into which we pay through our income tax.

But, if you suffer from dementia, your care is means-tested and delivered by private businesses for which you have to pay.

Integrated Care will not change this unfairness for those struggling to meet the bills for social care required as a result of dementia.

Based on all the bluster from the Prime Minister around last year’s Social Care White Paper, everyone would believe that the Government has solved the crisis in social care.

It has set out a vision for adult social care that provides quality tailored care and support to ensure everyone has choice, and control to live independently.

But the central funding allocated does not even meet the present funding gap, which leads to huge unmet need, chronic staff shortages and totally inadequate pay for care workers.

The Government’s ambitious plans for the next 10 years expect councils to conjure up the money from thin air. Councils are required by law to address the increased demand for social care services from a rapidly ageing population with no guarantee of the additional money needed. So all other council services, like road repairs, are cut to meet the shortfall. No wonder we are plagued by potholes in Staffordshire.

Plans for Integrated Care aim to bring the NHS and local government closer together to improve care for all and to get better value for money. But, for that to work, it has to be done on the basis of an equal partnership between the NHS and councils.

Sadly, from the outset, that appears not to be the Government’s plan.

Until the intervention of the House of Lords in amending the Health and Care Bill, elected councillors were even excluded from sitting on the Integrated Care Boards that will oversee the new integrated healthcare approach.

Although the Government emphasises the importance of measures to prevent ill health in its so-called ‘Levelling Up’ White Paper, it has cut councils’ public health grant by nearly a quarter in real terms since 2015/16.

That is a kick in the teeth to council public health directors and their teams, who worked so tirelessly to safeguard our communities during the covid pandemic in the face of the Government’s dither and delay.

But it also demonstrates the way this Government makes impossible demands on councils while refusing to fund them properly.

Integrated healthcare is a welcome initiative but it will be reduced to a meaningless sound bite if councils cannot fund their services – services which help keep people out of hospital, supported within their local community and off bulging NHS waiting lists which have never been so long.