Socialist Worker

The Tories' merger plan isn't about improving health or social care

The political consensus to merge social care and the health service would be a disaster, unless the cuts are stopped and more funding is provided, writes Raymie Kiernan

Issue No. 2411

More than 50,000 demonstrated for the NHS outside the Tory conference last September

More than 50,000 demonstrated for the NHS outside the Tory conference last September (Pic: Guy Smallman)


The slashing of council budgets by a quarter since 2010 means social care services are “unsustainable” the Association of Directors of Adult Social Services stated last week.

Fewer people who need the care now receive it. Cuts continue to reduce the service while demand for care rises. And fewer resources mean increasing workloads and pressure for workers.

The Tories have been forced to announce new money to the sector to avert a growing social crisis created by their austerity cuts. 

Their £3.8 billion Better Care Fund (BCF) is supposed to help integrate health and social care services. Integration is part of the grand plan of Tory ex-health minister Andrew Lansley’s Health and Social Care Act, which is privatising the NHS by stealth. 

The problem is the scale of the Tories’ austerity-driven crisis in both health and social care. It means the BCF’s funding is making one crisis worse to solve another.

Snatched

Almost £2 billion is to be taken from the hospitals budget and will be used to patch the gaping wounds in social care.

Workers and service users have borne the brunt of budget cuts and the introduction of the profit motive through outsourcing services.

Over 200,000 homecare assistants are routinely paid less than the national minimum wage because they are not paid for time spent travelling between home visits. These visits to provide care can often be as short as five, ten or fifteen minutes.

It is not just the coalition government that supports integrating health and social care.

Labour shadow health secretary Andy Burnham argues for it precisely on the grounds that it could address these problems by extending NHS standards.

But Ed Balls’ commitment to stick to Tory spending plans means it could have the opposite effect.

Currently health funding is ring fenced but social care is not. If they merge will either still be protected?

NHS care is currently free at point of delivery, while social care is means-tested. Could integration see means-testing then introduced by the back door into health? And would it accelerate privatisation?

There are key questions unanswered about how it will be funded, by how much and who will commission services. Also unclear is whether private providers will be allowed to bid for contracts. 

There are also crucial differences between health and social care services that could have huge consequences for the other.

Closer integration between services to ensure people do not fall through the net and receive the care they need is worth supporting.

Yet it’s clear the Tories are attacking the idea of any basic right to welfare, health and care services.

Vandalism

Burnham attacks Tory vandalism in the health service and pledges to repeal Lansley’s act. But he makes no commitment to end the market in health or social care. 

Some Labour insiders argue his integration plan is more about positioning himself to challenge Ed Miliband for the party leadership in the future.

A series of strikes by social workers and care workers over the last year show the scale of the crisis in the sector—and the way to fight back. 

If we ensure the momentum of the strikes are not thrown away we can stop cuts and privatisation. 

That’s how we can win health and social care services that put workers, patients and service users first, not private bosses.


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