Independent Review or Heath Robinson-esque Tinkering

Amidst the funding problems of the living wage, auto enrolment and squeezed LA funding, a Guardian article predicts that a major care provider will fail in 2016 and that we could see the strange rebirth of directly provided social care as councils find themselves forced to act as provider of last resort. The article suggests that determined leadership is required and new models of health and care. 

At the same time we we see three former health ministers calling for an independent cross-party commission into Health and Social Care, supported in an open letter to David Cameron from more than 40 prime independent organisations in the sector.

Norman Lamb, Stephen Dorrell and Alan Milburn warn that more than 25% of the population will be over 65 years old in 20 years, more than 3 million people will be 85 or older and warn that some predict a £30bn funding gap by 2020. They call for an integrated review so that public services are more flexible, reliable and focused on preventing illness rather than resolving health crises. Taking evidence  from the public, health staff, and other interested parties they aim to propose a new funding settlement. 

The supporting organisations include luminaries such as Care England, MacMillan Cancer, Independent Age, Marie Curie, Mencap and the MS Society. They ask for a Health and Social Care System that is fit for purpose; they ask for bold, long term thinking about the size shape and scope of services and an honest debate about how we pay.

These are not new issues, integration and funding are the two main elements of current debate. But have we not had some independent review? Dilnot was accepted and then shelved? Is there a political will to take this forward and create something remarkable or will short term responses to problems result in a structure that is more Heath Robinson than fit for purpose?

But.. being optimistic, assuming a commission goes ahead, what would you tell them? What evidence would you give? What suggestions would you put forward? Let us know!