Labour claims its idea of "whole-person care" can make crucial NHS savings. Photo: Getty
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Labour says joining up social care and health can plug the NHS budget shortfall

The Labour party says it would make savings in the NHS through joined-up services; what does this tell us about its approach to health policy in austere times?

The NHS can be the Labour party's most powerful weapon, but also its biggest stumbling block. While the party gains a great deal of warmth from the electorate for being associated with protecting the health service and its core value as being free at the point of use, and having been its founder, this also makes it vulnerable to criticism if it ever wants to so much as tweak its outlook or plans for health policy.

While the Conservative party, whose NHS reforms have been particularly controversial and unpopular, particularly among doctors and health workers, frenziedly attacks the opposition on the record of the Labour-led Welsh NHS, the Labour party has been beavering away attempting to figure out how it can maintain its reputation for being the party of the NHS while governing under austerity, if it reaches government in 2015.

The shadow health secretary, Andy Burnham, who served as health secretary when Labour was last in government, has been pushing his plan for “whole-person care” for a long while. The most basic definition of this rather clunkily-labelled plan (I’ve always thought it sounds a bit like a weird euphemism for undergoing general anaesthetic), is joining up health and social care, for a more holistic approach to caring for patients throughout their lives, and to stop physical, mental and social care being in separate compartments.

Today, the shadow care minister Liz Kendall is to lay out how joining up health and social care would be used by Labour to make savings in order to fund the shortfall in the NHS budget.

Burnham and his team have long been calling the “whole-person care” idea “efficient”, as well as a better service for the individual patient. He told me in February that the policy is “actually about efficiency” and “spending money we already put into the health and care system much better than we currently do.”

Hinting at Ed Miliband’s initial reticence over the plan – there was a time during the last Labour party conference when it was widely-thought Burnham would be reshuffled – Burnham also said in my interview that he was “assuming that there’s going to be no huge amounts of money for health and social care”, and asked “how do we get much better results for people from what we’re currently putting in? Whole-person care comes from that quite hard-headed assessment of the future outlook of public spending.”

The shadow health secretary also chuckled that upon nearly elbowing Ed Balls in the face at a football match they both took their children to, the shadow chancellor gave such a scowl that a man next to them joked: "I think you’ve just lost the NHS £10bn there in the next spending review". But jokes and violence aside, it's no secret that Balls, and Miliband, have been wary about Burnham's plans, reportedly blocking his idea to hand NHS cash to councils earlier this year.

However, this is the first time Labour’s health team has said its joined-up approach will specifically make savings to plug the apparently imminent “black hole” in the NHS budget. This suggests that the policy has finally received support from Miliband and Balls – indeed, Kendall’s announcement comes a few days after the shadow chancellor ruled out an estates tax or a national insurance hike as sources of funding.

In her speech today, Kendall will say:

Huge cuts to social care are piling further pressure on local hospitals. £3.5bn has been cut from local council care budgets since 2010 and a quarter of a million fewer older and disabled people are getting vital services like home care visits, which help them get up, washed, dressed and fed.

It will be a choice between care going backwards, with fragmented services and money wasted under the Tories – or Labour's plans to fully join-up the NHS and social care so we get the best results for users and the best value for taxpayers' money.

Labour still needs to clarify exactly how this policy will go towards patching up the £2bn shortfall in the NHS budget in England next year alone predicted by health officials, and also whether it is the best approach to the costly strains of an ageing population. But it seems that what it has achieved is some agreement between those holding the purse-strings in the party and Burnham – who is said privately to support an estates tax – and his health team.

Anoosh Chakelian is senior writer at the New Statesman.

How Jim Murphy's mistake cost Labour - and helped make Ruth Davidson

Scottish Labour's former leader's great mistake was to run away from Labour's Scottish referendum, not on it.

The strange revival of Conservative Scotland? Another poll from north of the border, this time from the Times and YouGov, shows the Tories experiencing a revival in Scotland, up to 28 per cent of the vote, enough to net seven extra seats from the SNP.

Adding to the Nationalists’ misery, according to the same poll, they would lose East Dunbartonshire to the Liberal Democrats, reducing their strength in the Commons to a still-formidable 47 seats.

It could be worse than the polls suggest, however. In the elections to the Scottish Parliament last year, parties which backed a No vote in the referendum did better in the first-past-the-post seats than the polls would have suggested – thanks to tactical voting by No voters, who backed whichever party had the best chance of beating the SNP.

The strategic insight of Ruth Davidson, the Conservative leader in Scotland, was to to recast her party as the loudest defender of the Union between Scotland and the rest of the United Kingdom. She has absorbed large chunks of that vote from the Liberal Democrats and Labour, but, paradoxically, at the Holyrood elections at least, the “Unionist coalition” she assembled helped those parties even though it cost the vote share.

The big thing to watch is not just where the parties of the Union make gains, but where they successfully form strong second-places against whoever the strongest pro-Union party is.

Davidson’s popularity and eye for a good photo opportunity – which came first is an interesting question – mean that the natural benefactor in most places will likely be the Tories.

But it could have been very different. The first politician to hit successfully upon the “last defender of the Union” routine was Ian Murray, the last Labour MP in Scotland, who squeezed both the  Liberal Democrat and Conservative vote in his seat of Edinburgh South.

His then-leader in Scotland, Jim Murphy, had a different idea. He fought the election in 2015 to the SNP’s left, with the slogan of “Whether you’re Yes, or No, the Tories have got to go”.  There were a couple of problems with that approach, as one  former staffer put it: “Firstly, the SNP weren’t going to put the Tories in, and everyone knew it. Secondly, no-one but us wanted to move on [from the referendum]”.

Then again under different leadership, this time under Kezia Dugdale, Scottish Labour once again fought a campaign explicitly to the left of the SNP, promising to increase taxation to blunt cuts devolved from Westminster, and an agnostic position on the referendum. Dugdale said she’d be open to voting to leave the United Kingdom if Britain left the European Union. Senior Scottish Labour figures flirted with the idea that the party might be neutral in a forthcoming election. Once again, the party tried to move on – but no-one else wanted to move on.

How different things might be if instead of running away from their referendum campaign, Jim Murphy had run towards it in 2015. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.

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