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 deputy web editor at the New Statesman.

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Theresa May gambles that the EU will blink first

In her Brexit speech, the Prime Minister raised the stakes by declaring that "no deal for Britain is better than a bad deal for Britain". 

It was at Lancaster House in 1988 that Margaret Thatcher delivered a speech heralding British membership of the single market. Twenty eight years later, at the same venue, Theresa May confirmed the UK’s retreat.

As had been clear ever since her Brexit speech in October, May recognises that her primary objective of controlling immigration is incompatible with continued membership. Inside the single market, she noted, the UK would still have to accept free movement and the rulings of the European Court of Justice (ECJ). “It would to all intents and purposes mean not leaving the EU at all,” May surmised.

The Prime Minister also confirmed, as anticipated, that the UK would no longer remain a full member of the Customs Union. “We want to get out into the wider world, to trade and do business all around the globe,” May declared.

But she also recognises that a substantial proportion of this will continue to be with Europe (the destination for half of current UK exports). Her ambition, she declared, was “a new, comprehensive, bold and ambitious Free Trade Agreement”. May added that she wanted either “a completely new customs agreement” or associate membership of the Customs Union.

Though the Prime Minister has long ruled out free movement and the acceptance of ECJ jurisdiction, she has not pledged to end budget contributions. But in her speech she diminished this potential concession, warning that the days when the UK provided “vast” amounts were over.

Having signalled what she wanted to take from the EU, what did May have to give? She struck a notably more conciliatory tone, emphasising that it was “overwhelmingly and compellingly in Britain’s national interest that the EU should succeed”. The day after Donald Trump gleefully predicted the institution’s demise, her words were in marked contrast to those of the president-elect.

In an age of Isis and Russian revanchism, May also emphasised the UK’s “unique intelligence capabilities” which would help to keep “people in Europe safe from terrorism”. She added: “At a time when there is growing concern about European security, Britain’s servicemen and women, based in European countries including Estonia, Poland and Romania, will continue to do their duty. We are leaving the European Union, but we are not leaving Europe.”

The EU’s defining political objective is to ensure that others do not follow the UK out of the club. The rise of nationalists such as Marine Le Pen, Alternative für Deutschland and the Dutch Partij voor de Vrijheid (Party for Freedom) has made Europe less, rather than more, amenable to British demands. In this hazardous climate, the UK cannot be seen to enjoy a cost-free Brexit.

May’s wager is that the price will not be excessive. She warned that a “punitive deal that punishes Britain” would be “an act of calamitous self-harm”. But as Greece can testify, economic self-interest does not always trump politics.

Unlike David Cameron, however, who merely stated that he “ruled nothing out” during his EU renegotiation, May signalled that she was prepared to walk away. “No deal for Britain is better than a bad deal for Britain,” she declared. Such an outcome would prove economically calamitous for the UK, forcing it to accept punitively high tariffs. But in this face-off, May’s gamble is that Brussels will blink first.

George Eaton is political editor of the New Statesman.