Britain's care system is at an inflection point. Changing
demographics and disease patterns - allied to rising public
expectations and dwindling public resources - are calling
into question the very sustainability of how health and
social care is delivered in our country. Muddling through
for another five or 10 years will no longer do. Something
has to give.
This important report sets out useful proposals to address the problems faced by
our health and social care system. It is welcome that the notion of integrating
services around the needs of patients and citizens is fast becoming a new
orthodoxy in public policy thinking. An older population with a high level of
co-morbidities makes a nonsense of the current sliced system of care split as it is
between primary, community, acute and social care. So too does the incidence
of physical health problems amongst those in need of mental health services.
Patients rarely fit the pigeon hole in which they find themselves.
It is time to turn the system on its head by starting with the needs of the patient
or citizen. They should not have to fit the care system. Instead, it should be
built around the very different needs of individual citizens. We are a very long
way from that being the case today. Social care has accountability structures,
funding methods, management structures and data systems that are separate
from its health care cousin. Yet they are part of the same family of care. It is time
to find ways of putting them closer together.
Doing so will not be easy. Change never is. It will require a new clarity of
direction and the courage to do things differently. In the NHS, new models of
care are now actively being built. But the NHS cannot do it alone. Leadership
that is willing to embrace change is needed at every level. That is why it is so
welcome that local government- which is busy reinventing and rejuvenating
itself - is also stepping up to the plate.
It gives good grounds for optimism that our care system can be reformed and
The Right Honourable Alan Milburn, Former Secretary of State for