England & Wales Health and social care

Happy Birthday NHS (but please don’t forget social care)

Image by Ingrid Koehler

Today marks the 70th Birthday of the NHS. As relative youngsters (the LGiU is about half your age) we congratulate you on the institutional longevity.

As individuals, we are profoundly grateful for the free access to health care and to those clinicians who have helped us in our own times of need. I used my local health services this morning and watched as the surgery staff typexed ’70’ on some blue balloons. There was a genuine and deserved sense of pride at being a part of what is a truly monumental achievement – aspiring to and delivering healthcare that is free at the point of delivery and transforming the health of a nation.

As a localist, I have some issues, particularly around the integration of health and social care. The National Health Service can do an amazing job of treating the catastrophic and the intermittent, but that there’s more work to do on treating individuals as whole people and on supporting individuals with chronic conditions and social care needs which may not be, but often are, related to declining health. The culture clashes and boundary issues between health and social care are monumental and illustrate the difference between a national service where we aim to have the same service for everyone and local services where we tailor the experience around local needs and local assets.

People live in families, in communities and in places and their health and wellbeing are intricately tied to that. Local government is the only accountable institution that can focus on developing community assets and making the links between individual, family, community, professional social care and yes, health, as well in the context of the places people actually live. We need a well-resourced national health system that addresses illness and injury, but we also need to ensure that wider needs are met, too. Social care sometimes seems like the unwanted guest at the birthday celebrations.

While we are pleased that the birthday celebrations for the NHS come with a big slice of cake in the form of extra money, it may prove a little dry if extra money cannot be found for social care, too. Many of the strains on the NHS stem from our societal inability to look after people at home and in the community.

The much delayed social care green paper has to really address the social care crisis and we must find root and branch reform to the way that we fund and access social care for those who receive state aid and those who are self-funding. It will not be easy and it will not be cheap. But unless we grasp the opportunity to fundamentally change social care funding and the way that social care is commissioned and delivered, the NHS’s 71st birthday may not be so happy.

We have every reason to celebrate the groundbreaking reform of providing healthcare for all and we should and we do. But we need to do more to make sure that people are just as well looked after when they need help to live healthy and independent lives, too.